Lesbian, Gay, Bisexual, and Transgender (LGBT) people are more likely to be disproportionally placed in a secured setting such jails, prisons, and forensic hospitals. These settings can be traumatizing, hostile, and dangerous—especially for those who are suffering from mental illness. Administrators are encouraged to develop institutional policies that undoubtedly include that LGBT residents should be free of discrimination, victimization, and abuse. LGBT residents should have equal access to safe housing, vocational programs, rehabilitation services, as well as medical and mental health treatments. Several organizations provide guidelines to ensure that LGBT residents are protected. This article provides a general roadmap for developing LGBT policies in secured settings synergizing the recommendations of some of these organizations with emphasis on policy guidelines for transgender people that are not only standards for good care but also very cost-effective interventions that can help reduce symptoms of mental illness for this population.