A dolescents and young adults (AYAs) with cancer are informed of their risk of sub-fertility and options for fertility preservation (FP) with the intention that, if possible, they are able to consider having biologically related children after treatment. Previous research indicates that assumptions of heterosexuality are a prevalent experience in healthcare among lesbian, gay, bisexual, and transgender (LGBT) populations. 1,2 Accordingly, pervasive heterosexual bias among providers may frame conversations on reproduction with AYAs with cancer, implying that fertility is only possible within a heteronormative cisgender (a person who identifies with their sex assigned at birth) opposite-sex relationship. 3 The purpose of this paper is to address the subpopulation of lesbian, gay, and bisexual (LGB) AYAs with cancer. The authors have intentionally chosen to focus on cisgender LGBs. Access to healthcare can be more stigmatizing and discriminatory for transgender populations than it is for cisgender sexual minorities 4 ; including transgender AYAs may indirectly promote comparisons to a cisgender norm. Thus, the unique experiences of the transgender community should be recognized independently. This paper will address issues of disclosure among LGB AYAs in healthcare and consider how providers can deliver informative FP options that are inclusive and respectful of LGB AYAs with cancer. The authors will draw on implications for healthcare practice and policy, and recommend strategies to enhance the applicability of educational materials and promote open and comprehensive practice.