This chapter examines lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) simulation in light of cis-heteronormativity’s impact, addressing healthcare inequities for this vulnerable population. This examination of the impacts of cis-heteronormativity highlights challenges in LGBTQIA+ medical care, emphasizing the need to avoid stereotypes. The narrative stresses healthcare simulation’s ethical responsibility to center LGBTQIA+ experiences and dismantle cis-heteronormative practices. Facilitation, prebriefing, and debriefing are discussed regarding psychological safety and cultural humility. Recommendations for inclusive care include pronoun sharing, zero tolerance for name/pronoun errors, gender-inclusive language, and diverse clinical examples. The text extends guidance to simulation operations, covering education, policies, and inclusive forms, and addresses equipment, recruitment, and training for LGBTQIA+ standardized patients. Considerations on voice, anatomy, and identity distinction underscore the intentionality required for LGBTQIA+ simulated participants. The chapter provides practical guidelines while highlighting the societal impact of healthcare simulation, perpetuating stereotypes and biases.