Abstract Compared to heterosexual cisgender-identified individuals, lesbian, gay, bisexual, and transgender and queer (LGBTQ) individuals evidence pronounced poor mental and physical health outcomes, as well as sub-optimal healthcare access and utilization. Yet, most of the evidence documenting these disparities comes from a small group of Western countries. This limited knowledge across health conditions and geographical regions leaves multiple important questions unanswered. In particular, it remains unknown to what degree these disparities may be generalizable to contexts that have not yet been studied. This workshop includes novel reports on disparities in health, wellbeing, and healthcare access between LGBTQ groups and their heterosexual cisgender counterparts across several European countries where such data were not previously available. Through these four presentations, we explore health inequalities across Europe in physical and mental health, as well as healthcare utilization. Findings emphasize a continued need for attention to systems that can be modified (e.g., trainings of healthcare cadre, resource allocation) to reduce health disparities that uniquely burden LGBTQ groups. Andreas Pfister (Zurich University of Applied Sciences, Switzerland) will present the first national systematically documented psychosocial burden and healthcare access disparities for LGBTQ individuals compared to their heterosexual cisgender counterparts in Switzerland. Sladjana Baros (Centre for Disease Prevention and Control, Department for HIV, Hepatitis, Sexually Transmitted Infections and Tuberculosis, Institute of Public Health of Serbia ‘Dr Milan Jovanovic Batut’, Republic of Serbia) will present findings from the HIV testing cascade among men who have sex with men at high risk for HIV. Michal Pitonak (Center for Epidemiological and Clinical Research of Drug Abuse and Dependence, National Institute of Mental Health, Klecany, Czech Republic) will present data on disproportionate rates of psychological distress reported by lesbian, gay and bisexual individuals compared to heterosexual individuals in the Czech Republic. Lastly, Luis Roxo (Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden) will present population-based data on differences in mental health services and unmet mental health needs based on sexual orientation among Swedish young adults. Key messages • Despite being the first of such evidence, findings from these four European countries are consistent with reports from other global regions, signalling that these disparities are universal. • A clear need emerges for structural changes to increase access to and expertise in affirmative LGBTQ healthcare to reduce disproportionate morbidity rates for LGBTQ people in Europe.