In this chapter, you will learn about the current and developing cancer health landscape as it intersects with Indigenous sexual and gender minority (SGM) populations, including Two-Spirit and Indigenous lesbian, gay, bisexual, transgender, queer, and another identity (LGBTQ+) communities. Background information and Indigenous Knowledge sharing is provided to build understanding of Indigenous gender spectrums, cancer health disparities among Indigenous populations, LGBTQ+ cancer health disparities, and Indigenous SGM health and cancer health disparities. The chapter is authored by Indigenous community leaders and researchers who identify in the Two-Spirit and Native LGBTQ+ communities and provides perspectives on challenges faced by SGM populations, emerging efforts to address SGM cancer health as well as recommendations for building equity and fairness for Indigenous SGM populations for future generations.