A growing number of LGBT people are starting families. The 2010 US Census reported that approximately 19% of same-sex couples are currently raising children, and a 2013 Pew Research national survey found that 51% of LGBT adults of any age have children or would like to have children in the future. As an increasing number LGBT individuals and couples seek to have children, many will turn to their health care providers for resources and guidance. This brief walks through the various pathways to parenthood for LGBT people, as well as unique issues these couples and individuals may face as they consider their options. The pathways explored in the brief include adoption and foster parenting, donor insemination and in vitro fertilization (IVF), and surrogacy. Also discussed are ways in which health care organizations can support LGBT parents. The brief can be used as a guide to tailor conversations about parenting desires with lesbian, gay, bisexual, and transgender patients.