People are diverse. They have different sexual and reproductive health needs that, in turn, require differentiated services to suit their unique biology, identity, behaviour, environment, and circumstances. A narrow range of generic, identical services provided to everyone – with no consideration for unique sexual orientation, gender identity or occupation, and the implications and conditions surrounding those identities – is not equally effective for everyone. Such services cater for some, but not for all. If equally effective sexual and reproductive health programming is the goal, differentiated services are necessary, supported by practical guidelines, service standards, clinical protocols and procedures, ways of thinking and working that make accessible, affordable, appropriate health available to sexual and gender minorities and sex workers.