Intimacy, including sexuality and sexual and reproductive health and rights (SRHR), is central to every family and couples counseling practice, in a direct or less direct way. Many unique challenges faced by international adoptees in intimate relationships are connected with negative sexual stereotypes as well as racism. In this article, I explore how societal structures influence sexual behavior and intersect with internalized racism, shaping expressions of intimacy. The article concludes with culturally affirming counseling practices designed to support adult adoptees' SRHR.