Homeless female adolescents in the United States have disproportionately high rates of pregnancy compared to general population youth. Little is known about how homeless youth decide whether to use birth control and which birth control method to select. The current study explores how homeless female youth participating in a holistic sexual health program called Wahine (“woman”) Talk experience this process, using data from in-depth interviews (N = 3) with 11 homeless adolescent girls. Data were analyzed using Interpretative Phenomenological Analysis, proceeding through reading and re-reading, initial noting, forming emergent and super-ordinate themes, repeating steps for each interview, and developing final themes and subthemes. Four final themes emerged, which, for most participants, were experienced sequentially: Getting Acclimated, Becoming Close and Building Trust, Addressing Fear, and Making the Choice. Study findings suggest that for homeless female youth, basic needs and relationship building must be addressed prior to the delivery of trauma-informed birth control-related content and effective linkage to (sexual) healthcare. Implications for practice, policy, and future research are discussed.