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Trans* identities are under-represented in UK sexual health data. One possible reason is that the traditional representation of gender within the restricted binaries of male and female contributes to the low numbers seen in sexual health services. We aimed to obtain a clearer understanding of the hidden gender and sexuality identities accessing an LGBT-targeted sexual health service.We offered full sexual health screening in a community LGBT clinic during National HIV Testing Week in 2016. A self-completed triage form was used to register patients. Additional gender identity options were added to the form. This included an ‘other’ box with an option to specify any gender or sexual identities that had not been represented on the form.78 patients completed the registration form. 52 identified as male and 18 female. 8 (10%) described different gender identities; 2 trans*-men, 2 demi-boys, 1 gender fluid, 1 bi-gender and 2 non-binary.In terms of sexual orientation, 8 identified as heterosexual men, 50 as gay men, 2 as lesbian women, and 6 (2 male, 3 female and 1 non-binary) as bisexual. 11 identified themselves as pansexual and 1 (a demi-boy) as asexual.Increasing the options during registration captured a wide variation in reported gender identity and sexual orientation. To avoid a complex, multi-option question on the registration form, we would suggest that simplifying this to ‘please describe your gender’ and ‘please describe your sexuality’ would be advantageous for both the patient and health care professional.