A teacher's capacity to provide sexuality education may be hampered or enhanced by a number of factors. A social-ecological framework can be used to understand these influences, and the present study assesses interpersonal, organisational/institutional and community/policy level influences on teaching sexuality education. Seven focus groups were conducted in 2009 with 41 sexuality education teachers in Minnesota; discussion focused on challenges and the supports teachers experienced. At the interpersonal level, teachers reported both positive and negative interactions with parents, regarding parents as highly influential on school administrators and policy. Teachers reported many organisational level challenges, including their administrators, district policy, and structural factors such as time, financial resources, and diversity in the student body. At the community level, participants overwhelmingly felt that policy changes could be very beneficial to sexuality education in Minnesota, and believed that this support could come from all levels. Findings suggest numerous intervention points to reduce challenges and strengthen supports for teachers, and indicate that a multi-level approach is needed to increase teachers' ability to deliver sexuality education that meets their students' needs and is less onerous for the educator. (Contains 1 table.)