Service providers working with youth involved in transactional sex (TS) encounter complex challenges in navigating systems of oppression facing youth and in addressing their own biases. Based on qualitative, in-depth interviews with 23 service providers in Kampala, Uganda, this study explores providers’ perceptions of service provision with youth engaged in TS, particularly adolescent girls and young women (AGYW), and lesbian, gay, bisexual, transgender, queer and other youth with marginalized genders and sexualities (LGBTQ+). The study analyzes how providers depict the drivers of TS, including systems of oppression, and considers apparent biases. Findings show that providers navigate fraught environments of oppression. Some use blaming frames, depicting youth behaviors. Others use coded language to engage youth, despite potential risks. Implications for practice are explored, including the potential of consciousness building a key strategy to address provider biases.