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Gay men experience disparity in health in many areas when compared with non-gay men and one response to this has been the development of gay-focused health policy. This article presents a critical review of 17 policy documents to investigate their adequacy (or otherwise) in attending to the health needs of gay men. Specific attention is paid to:(a) who gets a say in gay men’s health issues,(b) how gay men’s health is framed,(c) what is the role of the medical profession and gay men in gay men’s health, and (d) what is the role of research in establishing gay health needs. The findings suggest that gay men’s health is framed very negatively, highlighting deficits and problems, and largely offering individualised solutions for complex problems. It is suggested that a more holistic (and social) framing of health would allow the influence of sexuality to be properly accounted for; and a reorientation of research efforts to critically examine the existence and prevalence of discriminatory practices and discourses that work against population-level improvement in gay men’s lives is advocated. A greater role for gay men in these processes is recommended.