Individuals with physical, intellectual, and developmental disabilities reproductively mature at the same rate as the general population. However, they often lag far behind their peers in access to education about the emotional, social, and medical challenges that accompany the physical changes of the emerging adult. By the time a young adult with a disability or chronic condition reaches an internist, preventative reproductive health has largely been rationalized as not necessary or simply forgotten. Access to education and reproductive health services is essential for the development of a sense of self; establishing fulfilling physical and emotional relationships; and protection from abuse and poor outcomes that can be anticipated and prevented. The approach to a patient’s sexuality and reproductive health needs varies across disabilities and chronic conditions and may require the support of physicians in other specialties. Understanding that each patient is a sexual being who requires attention to his or her sexuality and reproductive health needs will optimize the mental health, safety, and general health outcomes across the spectrum of physical, intellectual, and developmental disabilities.