Lesbian, gay, bisexual, and transgender (LGBT) individuals may experience stress, stigma, and discrimination related to sexual and gender identities in school and clinic settings. This may adversely impact school participation and use of health services, and is related to sexual health risk behaviors and rates of STD/HIV. Creating supportive environments for LGBT students and patients is a promising strategy to increase access to school and clinic settings and to health-related programs and services. The first presentation will focus on work in CDC’s Division of Adolescent and School Health, in which Dr. Rasberry will present data related to school climate for LGBT students and will briefly describe approaches to creating safe and supportive environments for these youth. In the second presentation, Dr. Radix will demonstrate how clinics can be safe and welcoming to LGBTQ patients and create friendly environments that facilitate disclosure of gender identity and sexual orientation. The final presentation will focus on the use of secret shoppers as an approach to evaluation in community-based STI testing settings. Dr. Bauermeister will highlight opportunities and challenges that might emerge when employing this quality assurance tool.