Abstract
School-based health centers are ideally situated to provide sexual health services to adolescents but face a macropolitical climate with competing sets of interests. We apply an organizational theory to 2019-2021 interview data from 33 school-based health center (SBHC) coordinators and their educator partners in Oregon to reveal the micropolitics that coordinators engage in to provide sexual health services to adolescents. Interviewees described how health practitioners' interest in providing sexual health services conflicts with anti-contraception, puritanism, and parental rights interests across school boards, parents, students, and the public. SBHC coordinators strategically engage their influential power by building relational trust with educator partners, students, and parents. They also employ the micropolitical strategy of compromise, avoiding pushing too hard for their ultimate interests to maintain the relational trust and interests they have already achieved. These findings provide a parallel for research focused on other systems, especially systems also characterized by morality-based conflict.