The design of health policies must be guided by the imperative of sex and gender inclusiveness in order to advance the health of all. Classically conceived from the idea of universalism, the French conception of health policies is however often categorical when it comes to questions linked to sex and gender, even though health topics are rarely specificaccount. This article examines this tension in the design of public policies that can improve the health of sexual and gender minorities, between "neutral" or "universal" policies and categorical, "sexed" or "gendered" policies. The report Sex, Gender and Health published by the HAS in 2020 bears this conviction that concerning sex, gender and health, the principle of proportionate universalism is the most suitable for improving the health of all, without prejudice but also without privilege, nor for the general population, nor for the minorities that compose it. The authors question the design of public health policies with regard to sexual and gender minorities, seeking the relation between the preservation of the general interest and special interests. It is therefore a question of using the concepts of "sex" and "gender" as levers for improving the health of all, and not as tools for defining categorical policies.