This work considers ‘nothing’ and its effect upon the reproduction of ignorance and epistemic exclusion, by interrogating a decision to ‘do nothing’ made by the World Health Organisation (WHO). As a functional international organisation, its policymaking is enacted through the interplay and negotiation of scientific knowledge, international legality, and state will. In this context, the thesis contains two parts. In Part I, I look at the discussions between states over health inequities experienced by sexual and gender minorities (SGMs) from 2013 to 2016, which resulted in permanently deleting the agenda proposal in question. In Part II, drawing on and looking beyond the sociology of nothing and the sociology of ignorance, I propose normative and critical policy interventions into the discursive practices that have allowed such indecision and inaction to be justified. Therefore, this study demonstrates that nothing is productive, lending itself to a rhetorical use of sovereignty in order to circumvent a global response to SGM health injustices. This study identifies the complex power-knowledge nexus, particularly in a field in which legal, political and health discourses are competing for authority over policy legitimacy. In this respect, I employ ‘lack/lacking’ as an analytical concept in capturing the variable relationships between nothing (negative social phenomena) and ignorance (the limits of knowledge). In the current case, states have asserted something that is required/desired (e.g. interstate consensus, global definition, scientific evidence) is lacking, using this to justify the WHO’s inertia, which, however, has reinforced SGMs’ vulnerability across societies. Along with presenting the disappearance of that agenda proposal, I also presentify, based on the decolonial-queer praxis, a critical reimagining of what if another knowledge were/is possible. Taking ‘nothing happened’ as a point of departure for analysis, this study contributes to a better understanding of the production and functioning of ignorance, especially for the studies concerning multilateral policymaking such as international law and political sociology.