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India's adolescent health policy aims to improve sexual and reproductive health, especially amongst the most vulnerable. There is limited evidence on how gender influences treatment-seeking patterns amongst unmarried adolescents. This study found that while at least two-thirds of boys sought care for sexual health approximately one in four girls did so. Boys primarily sought care from medical shops or private facilities, while girls used both private and government services. This study highlights that stark sex differentials in factors associated with symptoms and treatment-seeking behaviour illustrate the structural gender inequities, such as access to economic resources and education, influence sexual and reproductive health amongst adolescents. Along with health system interventions, addressing gender inequities calls for strategies to strengthen parental engagement, social support and girls’ access to resources. This article can provide useful insights to program implementers. Click here to read the article.