ABSTRACT
This chapter sets the stage for the broader discussion in the book by exploring the historical and contemporary contexts of LGBTQ+ health within exclusionary health systems. It highlights how health services, rooted in cisheteronormative models, create significant challenges and legal barriers for LGBTQ+ individuals. This includes introducing the impact of inequalities on health outcomes and how exclusionary practices and poorer treatment are linked to adverse results. Key issues highlighted include the lack of inclusive language and data collection practices, the need for recognition of non-biological and non-gestational parents, and the barriers faced by LGBTQ+ individuals in accessing fertility treatments and adoption services. The primary aim is to provide a foundational understanding of these critical issues and to emphasise the necessity of advocating for structural changes to support inclusive, culturally humble, and competent perinatal care from preconception to post-birth. In closing, the chapter underscores the importance of patient-centred approaches and the ongoing need for education and support to ensure equitable care for all families.
