<p>Rural communities, in the United States, often have limited access to reproductive services and information about reproductive health. This study aimed to better understand first sexual experiences for girls in rural Missouri. Factors that were explored included age, consent, and contraceptive use during their first sexual experience. These results show that two-thirds of the sample engaged in sexual intercourse by the age of 16 and the majority (53%) did not use contraception during their first sexual experience. Also, rural Missourian girls are experiencing higher rates of nonconsensual sex for their first sexual experience, compared to the wider population of American adolescents. These disproportionate sexual health risks for the underserved rural population underscore the need for more thorough and abundant research concerning rural communities. With greater knowledge, policymakers, teachers, parents, and clinicians can help better prepare and protect rural girls as they enter adolescence.</p>