People with intellectual and developmental disabilities have the right to access appropriate and comprehensive sexuality and relationship education (SRE), but face a long history of exclusion from SRE in the USA due to myths about the sexuality of people with intellectual and developmental disabilities, biases against people with disabilities, and segregationist educational policies. Additionally, people with autism/autistic people are more likely to report having an LGBTQIA+ identity, and need comprehensive SRE content to become socially competent members of their communities. Teachers and other practitioners are often placed in the uncomfortable position of addressing many SRE topics while feeling unprepared, trying to stay aligned with educational policies, managing caregiver expectations, and providing scientifically accurate fact-based information in an increasingly politicised social climate. This paper provides recommendations on how to teach about LGBTQIA+ issues to students with intellectual and developmental disabilities including recommendations for modifying existing SRE curricula, identifying effective instructional strategies, and outlining a process for including LGBTQIA+ identities in SRE content.