This article examines the nature of sexual violence in the lives and relationships of lesbians, gay men, bisexuals, and transgender individuals and couples. Despite the concerns regarding disclosure, figures suggest a higher incidence of sexual abuse for gender and sexual minorities than for the general population. This abuse encompasses both hate crimes as well as abuse within intimate partner relationships and, for those who are transgender, there is a heightened incidence of sexual violence. Attention has also been focused on the damaging effects of sexual assault on the health and well-being of its victims, including mental health concerns, self-destructive behaviours, and attempted suicide. Several case scenarios are used to highlight the existence of discrimination, rejection, and abuse (including sexual abuse) within friendship networks and intimate partner relationships for those identifying as lesbian, gay, bisexual, and trans. This article concludes with an examination of clinical considerations and implications for practitioners in working with difference and attending to implicit bias.