I am delighted to have been asked to write the foreword for this book, Lesbian, gay, bisexual and trans health inequalities: International perspectives in social work, especially because I have lived my life as an openly gay male of African descent in the United States. Over the years I have had the opportunity to watch the emergence of the lesbian, gay, bisexual, trans and queer (LGBTQ) community from the shadows, while at the same time participating in the work needed to ensure that globally all LGBTQ people are able to live out their lives safely, healthily and openly.

Recent anti-LGBTQ actions in India, Russia and Uganda, as well as heated protests and resistance in France as the government there moved to make same-sex marriage legal and allow same-sex couples to adopt, show that there is still work to be done. According to an article that appeared in The Guardian newspaper in November 2013, currently 41 out of 53 Commonwealth countries have laws that allow for discrimination of LGBTQ people and more importantly this topic is not on their agenda (Davidson, 2013).

The primary mission of the social work profession is to enhance human wellbeing and help to meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed and living in poverty. A historic and defining feature of social work is the profession's focus on individual wellbeing in a social context and the wellbeing of society. Fundamental to social work is attention to the environmental forces that create, contribute to and address problems in living.

As professional social workers we know that individuals who are lesbian, gay, bisexual or trans are members of every community. LGBT people are diverse, come from all walks of life and include people of all races, ethnicities and ages, they are from all socioeconomic statuses and they exist in all parts of the globe.

In addition to considering the needs of LGBT people in programmes designed to improve the health of entire communities, there is also a need for culturally competent medical care and prevention services that are specific to this population. Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats.