This Kaiser Permanente handbook is the second edition of the Provider’s Handbook on Culturally Competent Care: Lesbian, Gay, Bisexual and Transgender Population. This edition contains updated information and presents a new section on Intersexuality. The term “culturally competent care” describes the delivery of health care services that acknowledges and understands cultural diversity in the clinical setting, respects members’ health beliefs and practices, and values cross-cultural communication. Increasingly, consumers are evaluating health care organizations for their ability to provide such care. Additionally, studies now indicate that sexual orientation and gender identity are as important as age or race in understanding health care utilization patterns and cost of care.