Safeguarding adults policy and practice offers person-centred and strengths-based support to people with care and support needs who cannot protect themselves from experiences of abuse and neglect. Little is known about how lesbian, gay, bisexual, transgender or queer (LGBTQ+) adults experience these processes, but a range of factors may place them at greater risk of abuse, particularly due to hostility, discrimination, and inequalities. This article sets out to explore the ways in which LGBTQ+ adults with care and support needs are represented in English Safeguarding Adults Reviews (SARs) and reports on documentary analysis of twenty-seven SARs and focus group discussions with fourteen SAR reviewers. Our findings illustrate that LGBTQ+ lives are framed as difficult, unacknowledged, transgressive, and unequal. The article concludes with a discussion that applies critical and queer theories to these findings, ultimately arguing that safeguarding practice is not currently addressing the needs of this group consistently and indeed, may cause further systemic harm through non-affirmative, hetero/cis-normative, discriminatory, or other hostile practices. One way forward is to adopt queer-oriented strengths-based approaches that centre joy, aliveness, and the liveability of life, alongside an understanding of systemic and structural harm. We argue this may offer more affirmative safeguarding support for LGBTQ+ adults.