Just having a chapter on the lesbian, gay, bisexual, and transgender (LGBT) community in the context of a book on Islamophobia and psychiatry is surely controversial, complicated, and critical. It is controversial because venerated and reputable Muslim scholars argue that homosexual behavior is forbidden in Islam, thereby disqualifying those who do engage in it from still being considered Muslim. It is complicated because such people may still want to identify themselves as both Muslim and lesbian, gay, or bisexual. Those in this political and social grouping who are transgender in terms of gender identity are different in the sense of their Islamic acceptance and can be either homosexual or heterosexual in their sexual orientation. It is critical because the LGBT people have been reported to have the highest rates of psychiatric problems and have been known to experience a triple stigma: the stigma of mental illness per se, the stigma that still exists toward LGBT people, and the stigma attached to Islam if an LGB individual is perceived to be Muslim. Adding to those challenges can be the experience of conflict between sexual orientation and religious tenets. Compassionate and clinically sound methods to overcome these obstacles are presented.