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In recent years there has been an increase in both academic and political attention towards LGBT people in prison, and last year the British government updated its legislation on the treatment of transgender inmates. In this paper I outline the national-level policies, and institutional-level provisions, for LGBT prisoners in England and Wales. Drawing upon primary research with LGBT prisoners across the UK, I consider their significance to prison staff, and their effects upon inmates. I emphasise the significant diversity of experiences that LGBT inmates have depending on the institutions that they are housed within. I illustrate the benefits that can accompany effective support services, and the dire consequences of failing to provide appropriate care for LGBT prisoners. Finally, I explain the barriers to good-quality support for gender and sexual minority inmates, and suggest ways that they could be overcome.