This article examines the impact of federalism on reproductive and sexuality rights in Canada. It highlights an important problem in rights implementation triggered by the particular division of jurisdiction in these policy areas. Despite favorable Supreme Court rulings recognizing the essential validity of these actions (namely access to abortion and contraception, and marriage between same-sex partners), cooperation by another level of government is necessary in order to implement access. Huge variation exists in the extent to which provincial and territorial governments have implemented access in law and policy. The article points to an important research agenda on rights implementation that moves beyond analysis of formal responses postjudicial review to consider the impact of divided jurisdiction.