This chapter explores the healthcare experiences of sexual and gender minority (SGM) populations, addressing their access to and utilization of care through historical, structural, and social lenses. It begins by defining SGM identities and highlighting unique health disparities, including elevated rates of chronic illness, mental health conditions, and substance use, driven by discrimination, stigma, and systemic barriers. The chapter then examines historical shifts in SGM healthcare access, including the pathologization of homosexuality, the HIV/AIDS epidemic’s impact, and major policy milestones like the Affordable Care Act and marriage equality. Next, current healthcare disparities are explored alongside the barriers SGM individuals face, such as geographic isolation, economic inequalities, and lack of culturally competent providers. Special attention is given to intersectionality, revealing how overlapping identities like race, age, socioeconomic status, and disability compound barriers for subgroups. Moreover, the chapter underscores the need for culturally competent care and presents evidence-based solutions, like provider training, specialized clinics, policy reforms, and telehealth. Finally, it outlines future research directions to address gaps, such as understanding underserved SGM subgroups, expanding intersectional analyses, and integrating SGM health topics into global healthcare systems. By addressing these issues, the chapter offers a roadmap to promote equity and improve healthcare outcomes for SGM populations.