Background <p>Sexual health and access barriers have become increasingly important, especially given the rising divorce rates and marital dissatisfaction linked to sexual health literacy. This qualitative study aims to explore the barriers and solutions affecting service provision in sexual health clinics (SHCs) in Sari, Iran, from the perspectives of key stakeholders.</p> Methods <p>This qualitative study was conducted from July to October 2024 using a conventional content analysis approach. It involved in-depth, semi-structured interviews, and Focus Group Discussions (FGDs) with a diverse group of participants. Data saturation was achieved after engaging with four policymakers, four specialists, 26 clients, and 120 health providers.</p> Results <p>The findings reveal three main categories: Challenges, Opportunities, and Solutions. Under Challenges, structural, socio-cultural, professional and organizational, and service-related challenges were identified. Opportunities highlighted university capacities, alignment with national policies, autonomy, and effective leadership strategies. Proposed solutions included resource development, the implementation of evidence-based practices, and de-labeling efforts to reduce the stigma surrounding sexual health.</p> Conclusion <p>The study emphasizes the need to enhance sexual health literacy and improve access to sexual health centers in Iran through infrastructure development, educational initiatives, and open dialogue to reduce stigma. Addressing these challenges can better meet the population’s sexual health needs and improve overall health.</p>