Due to a lack of published information and as part of Devon County Council’s equality duty, Sarah Bird, Advanced Public Health Practitioner, Public Health Devon, led a detailed health needs assessment of lesbian, gay, bisexual and transgender (LGBT) people[http://www.sciencedirect.com/science/article/pii/S0091743514003582] to inform the Devon Joint Health and Wellbeing Strategy. The needs assessment found that LGBT people have significantly higher levels of depression, anxiety, self-harm and suicidal ideation. LGBT people who also have other minority/protected characteristics are at even greater risk. From the perspective of sexual health, men who have sex with men remain a priority group for HIV prevention and early diagnosis, while sexual health for lesbian women and transgender people is often an invisible and poorly addressed area of need. Rates of smoking in LGB people in Devon are significantly higher than in the general population, and levels of drug and alcohol abuse are significantly higher in LGBT people. Lesbian and bisexual women are as likely to, and gay and bisexual men are more likely to, experience domestic abuse as their heterosexual counterparts. LGBT youth may face rejection and abuse from their families. Young LGBT people are more likely to suffer from depression, anxiety, self-harm, suicidal ideation and have higher levels of smoking, alcohol and substance abuse. This is likely to be linked to stress from isolation, bullying and harassment. Homophobic and transphobic bullying is common in schools and can be aimed at anyone who does not fit in to societal expectations of gender or sexual identity (whether they are ‘out’ or not). Older LGBT people are not confident that health and care services are able to provide for their needs in a culturally sensitive way. Older LGBT people are less likely to have children and more likely to live alone. The findings for young people were reinforced by the engagement undertaken as part of the development of the Devon Early Help strategy[http://www.devonhealthandwellbeing.org.uk/library/needs-assessments/].