This is a study of how heterosexual girls construct the meaning of their health issues within their dating relationships. We found that a number of barriers contributed to girls' difficulty with articulating their needs and desires in their romantic relationships. Adolescent girls who participated in our study blamed themselves for their boyfriends' abuse and lack of commitment and experienced their ability to speak in their own interests as compromised. Many of the girls experienced what researchers term an "impossible choice" between compromising self to maintain a relationship or compromising the relationship to maintain self. The dating relationship was predominantly determined by patriarchal and dualistic thinking that undercut healthy decision making. Assisting girls within supportive environments to reflect upon gendered power differentials in their relationships can facilitate their expression of authentic voice which in turn can enhance their own health behaviors.