This chapter compares lesbian, gay, bisexual, transgender and queer (LGBTQ) rights, politics and workplace inclusion in South Africa (SA) and the USA. We explore the histories, backgrounds and legal landscapes of LGBTQ rights, and highlight relevant trends and current issues pertaining to LGBTQ issues in the two countries. We utilize Reynaud’s theory of social regulation (1979) to analyze social regulation involved in LGBTQ equal opportunities and inclusion, in historical, current coalitions and political debates in the two countries. We conclude that SA has a higher level of national control regulation than the USA, with more laws of national scope in place creating a broad pattern of progressive legislation towards LGBTQ equality. Regarding the autonomous societal rules activated spontaneously by actors, we conclude that the USA has taken the lead over SA in the relatively widespread acceptance of LGBTQ people in American society and in broad voluntary employer action. We found there is no straight line of progress in advancing LGBTQ rights, in either the USA or SA. We recommend that SA should build stronger cooperative ties beyond Africa to increase gay and lesbian social acceptance and to prevent anti-gay and lesbian violence. In the USA more formal regulation at the federal level is needed, where federal law addresses full LGBTQ rights and where federal court decisions affirm rights to constitutional equal protection in all arenas of life.