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Background: Access to health care is a right for all. However, what we have observed is that when it comes to the inclusion of sexual minorities, this right has been curtailed, and their demands have been made invisible. Objective: to analyze the context in which the documents were produced, understanding the process of inclusion in the Brazilian government's agenda, as well os its consequences in the context of health practices. Method: Documentary study. Results: after analysis, the following categories were formed: context of policy formulation, influences that affected the policies and developments of political principles and reflections on the health of lesbians. Conclusion: The challenges regarding the demands and specificities of lesbians, within the scope of PNAISM and LGBT Policy, persist and result from the failure to consider sexual orientation as a strong indicator of the health-disease process, in addition to the invisibility of female diversity in government proposals, as well as weaknesses in the training/qualification process of professionals involved in caring for users.