According to the Federation of Gay Games (FGG), fourteen cities expressed interest in hosting the event.

During its annual meeting in Cape Town on October 28, 2008, the FGG announced that four American cities made the deadline and were thus in the running to host the games: Boston, Cleveland, Miami, and Washington, D.C. Of these cities, Boston, Cleveland, and Washington, D.C. submitted bid books by the deadline.

The FGG selected Cleveland as the host city on September 29, 2009 during its annual meeting in Cologne, Germany.

Featured stars at the ceremony included singer, dancer and radio host Lance Bass, Broadway actress Andrea McArdle, Alex Newell from Glee, former Olympian Greg Louganis, and The Pointer Sisters.

[51][52] Kinnon MacKinnon, at age 28, became the first openly transgender man to earn a gold in powerlifting at the Gay Games.