Lesbians, gays, bisexual and transgender (LGBT) individuals have specific problems related to migration, adjustment and acculturation. In this chapter, the process of coming out and related issues, homophobia and heterosexism and bi-negativity are highlighted. It attempts to link these attitudes with migratory and post-migratory experiences, and explores specific issues in managing LGBT individuals. The number of LGBT individuals migrating and/or seeking refuge or asylum will vary according to a number of factors. In addition to the usual factors affecting migrants, there are specific complicating factors related to sexual identity. LGBT individuals may or may not feel comfortable with their own sexual identity, which will be influenced by social, biological and cultural factors. Coming out is described as the cultural process of gay existence. Homophobia is a term used to describe anti-homosexual feelings related to prejudice and negative attitudes expressed by individuals against gays and lesbians.