Background Sexual and gender minorities (SGM) experience many disparities in sexual health. College health centers must address early inequities for this population. Local Problem Significant access disparity was noted for SGM students at a small urban college health center. The aim of this quality initiative was to increase equitable access by 20% over 90 days. Methods A rapid‐cycle quality improvement project was initiated using a Plan‐Do‐Study‐Act model. Interventions Templated nurse‐led visits, a discussion starter tool, and an inclusive care checklist were introduced, with assurance of equity for each metric, and a focus on team collaboration. Results Access to sexual health services increased by 22.6% over 8 weeks with SGM utilization increasing 2.7‐fold. Guideline‐concordant care improved by 94% for all students. Student comfort scores (Likert range 1–5) also improved, from a baseline of 3.53 to a project mean of 4.62. Conclusions This project addressed equity in a college health setting through improved student engagement, targeted workflow innovation, and enhanced team collaboration. Application of key findings to other health topics will continue to mitigate disparities in college health centers. Tools may also be applied to adolescent and adult primary care settings to improve patient comfort and SGM‐inclusive sexual health service delivery.