This chapter focuses on the special populations in rheumatology, specifically the LGBTQIA+ community. The chapter begins with two patient stories that highlight the challenges faced by LGBTQIA+ individuals in healthcare settings. The chapter emphasizes the importance of providing holistic and affirming care to diverse populations. It discusses the background of nondiscrimination laws and the recognition of healthcare disparities within the LGBTQIA+ community. The chapter explores the relevance of LGBTQIA+ identity in rheumatology and highlights the need for healthcare providers to be knowledgeable and aware of LGBTQIA+ health issues. It provides guidance on direct practice, including recognizing privilege, addressing biases, using gender-neutral language, and following the patient’s lead. The chapter also emphasizes the importance of continuous learning and creating safe spaces for LGBTQIA+ patients.