Many variants of the term LGBT exist, such as the more inclusive LGBT+, and variations that change the order of the letters or include additional letters. At least some of the components of sexuality (regarding hetero, bi, straight), and also gender are stated to be on different spectrums of sexuality. Other common variants also exist, such as LGBTQIA, with the I standing for intersex and the A standing for asexual, aromantic, or agender, and LGBTQIA+, where "the '+' represents those who are part of the community, but for whom LGBTQ does not accurately capture or reflect their identity". Longer initialisms have been criticized as confusing or unwieldy, sometimes being referred to as "alphabet soup", and mocked with labels such as LGBTQWERTY, LGBTQXYZ, and alphabet mafia. The implication that the initialism refers to a single community is also controversial.

Although identical in meaning, LGBT may have a more feminist connotation than GLBT as it places the "L" (for "lesbian") first. LGBT may also include additional Qs for "queer" or "questioning" (sometimes abbreviated with a question mark and sometimes used to mean anybody not literally L, G, B or T) producing the variants LGBTQ and LGBTQQ. The order of the letters has not been standardized; in addition to the variations between the positions of the initial "L" or "G", the mentioned, less common letters, if used, may appear in almost any order. In Hebrew and Peninsular Spanish, LGTB (להט"ב) is used, that is, reversing the letters "B" and "T". Variant terms do not typically represent political differences within the community, but arise simply from the preferences of individuals and groups.

The terms pansexual, omnisexual, fluid and queer-identified are regarded as falling under the umbrella term bisexual (and therefore are considered a part of the bisexual community). Some use LGBT+ to mean "LGBT and related communities". Other variants may have a "U" for "unsure"; a "C" for "curious"; another "T" for "transvestite"; a "TS", "2S", or "2" for "two-spirit" persons; or an "SA" for "straight allies". The inclusion of straight allies in the LGBT initialism has proven controversial, as many straight allies have been accused of using LGBT advocacy to gain popularity and status in recent years, and various LGBT activists have criticised the heteronormative worldview of certain straight allies. Some may also add a "P" for "polyamorous" or "pangender", an "H" for "HIV-affected", or an "O" for "other". The initialism LGBTIH has seen use in India to encompass the hijra third gender identity and the related subculture.

Adding the term allies to the initialism has sparked controversy, with some seeing the inclusion of ally in place of asexual/aromantic/agender as a form of LGBT erasure. Ther…

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The initialisms LGBT or GLBT are not agreed to by everyone that they encompass. For example, some argue that transgender and transsexual causes are not the same as that of lesbian, gay, and bisexual (LGB) people. This argument centers on the idea that being transgender or transsexual has to do more with gender identity, or a person's understanding of being or not being a man or a woman irrespective of their sexual orientation. LGB issues can be seen as a matter of sexual orientation or attraction. These distinctions have been made in the context of political action in which LGB goals, such as same-sex marriage legislation and human rights work (which may not include transgender and intersex people), may be perceived to differ from transgender and transsexual goals.

A belief in "lesbian and gay separatism" (not to be confused with the related "lesbian separatism") holds that lesbians and gay men form (or should form) a community distinct and separate from other groups normally included in the LGBTQ sphere. While not always appearing in sufficient numbers or organization to be called a movement, separatists are a significant, vocal, and active element within many parts of the LGBT community. In some cases separatists will deny the existence or right to equality of bisexual orientations and of transsexuality, sometimes leading to public biphobia and transphobia. In contrasts to separatists, Peter Tatchell of the LGBT human rights group OutRage! argues that to separate the transgender movement from the LGB would be "political madness", stating that:

Queers are, like transgender people, gender deviant. We don't conform to traditional heterosexist assumptions of male and female behaviour, in that we have sexual and emotional relationships with the same sex. We should celebrate our discordance with mainstream straight norms.

The portrayal of an all-encompassing "LGBT community" or "LGB community" is also disliked by some lesbian, gay, bisexual, and transgender people. Some do not subscribe to or approve of the political and social solidarity, and visibility and human rights campaigning that normally goes with it, including LGBT pride marches and events. Some of them believe that grouping together people with non-heterosexual orientations perpetuates the myth that being gay/lesbian/bi/asexual/pansexual/etc. makes a person deficiently different from other people. These people are often less visible compared to more mainstream gay or LGBT activists. Since this faction is difficult to distinguish from the heterosexual majority, it is common for people to assume all LGBT people support LGBT liberation and the visibility of LGBT people in society, including the right to live one's life differently from the majority. In the 1996 book Anti-Gay, a collection of essays edited by Mark Simpson, the concept of a 'one-size-fits-all' identity based on LGBT stereotypes is criticized for suppressing the individuality of LGBT people.

Writing in the BBC News Magazine in 2014, Julie Bindel questions whether the various gender groupings now, "bracketed together[,] ... share the same issues, values and goals?" Bindel refers to a number of possible new initialisms for differing combinations and concludes that it may be time for the alliances to either be reformed or go their "separate ways". In 2015, the slogan "Drop the …

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Many have expressed desire for an umbrella term to replace existing initialisms. Queer gained popularity as an umbrella-term for sexual and gender minorities in the 21st century. The term remains controversial, particularly among older LGBT people, who perceive it as offensive due to its historical usage as a slur, as well as those who wish to dissociate themselves from queer radicalism, and those who see it as amorphous and trendy. Some younger people feel queer is a more politically charged, more powerful term than LGBT. In a 2018 U.S. study, about 1 in 5 LGBTQ people identified as "queer".
SGM, or GSM, an abbreviation for sexual and gender minorities, has gained particular currency in government, academia, and medicine. GSRM is also used to include romantic minorities such as aromanticism.

In New Zealand, New Zealand Human Rights Commission uses "Rights of Sexual and Gender Minorities" to discuss LGBT rights.

In India, the Constitutional Bench of the Supreme Court of India, when decriminalizing homosexuality in the case of Navtej Singh Johar v. Union of India (2018), said:

Individuals belonging to sexual and gender minorities experience discrimination, stigmatization, and, in some cases, denial of care on account of their sexual orientation and gender identity. However, it is important to note that 'sexual and gender minorities' do not constitute a homogenous group, and experiences of social exclusion, marginalization, and discrimination, as well as specific health needs, vary considerably. Nevertheless, these individuals are united by one factor - that their exclusion, discrimination and marginalization is rooted in societal heteronormativity and society's pervasive bias towards gender binary and opposite-gender relationships, which marginalizes and excludes all non-heteronormative sexual and gender identities.

In the US, the term "Sexual and Gender Minority" has been adopted by the National Institutes of Health, the Centers for Medicare & Medicaid Services and the UCLA Williams Institute, which studies SGM law and policy. Duke University and the University of California San Francisco both have prominent sexual and gender minority health programs. An NIH paper recommends the term SGM because it is inclusive of "those who may not self-identify as LGBT ... or those who have a specific medical condition affecting reproductive development". A publication from the White House Office of Management and Budget states, "We believe that SGM is more inclusive, because it includes persons not specifically referenced by the identities listed in LGBT."

A UK government paper favors SGM because initials like LGBTIQ+ stand for terms that, especially outside the Global North, are "not necessarily inclusive of local understandings and terms used to describe sexual and gender minorities". An example of usage outside the Global North is the Constitution of Nepal, which identifies "gender and sexual minorities" as a protected class.
In Canada especially, the term 2SLGBTQ+ is seen, with the first two characters standing for two-spirit; the whole term stands for two-spirit, lesbian, gay, bisexual, trans, queer and questioning, and is intended as a term encompassing all sexual- and gender-minorities. For some indigenous people, two-spirit invo…

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