Much has been written about the NGOization of civil society in the Middle East and its consequences, with scholars writing about NGOs as instruments in the bureaucratization of and, therefore, limiting of activism, and as tools of cultural co-optation by the West (Ali 2018; Abdo, 2010; Qassoum, 2003; Jad, 2003; Hammami 1995). In what would come to be an influential argument, Massad drew a link between cultural imperialism and the NGOization of LGBT activism. Massad’s framework, however, leaves something to be desired. While it is important to examine the consequences of NGOization, less attention has been paid to the causes behind its contemporary appeal in the Middle East, especially as it relates to advocacy around gender and sexual rights. This paper argues for the need to pay attention to forms of grassroots political organizing that predate the proliferation of NGOs in the region, and to the role that their failure to endure played in enabling the popularity of the NGO model. Taking Lebanon as its focus, it examines the role the inability to build a lasting, inclusive leftist alternative played in the NGOization of gender and sexual rights in the country. In particular, the paper looks at Helem – the first LGBT rights group in the Middle East – and its evolution from a node in a wider leftwing network to an NGO with a more circumscribed remit. The paper examines routine collaborations between Helem and the Leftist Assembly for Change, established in 2005 by queer and feminist leftists and their allies, with which Helem shared members and a meeting space. The Assembly was created by activists who sought a holistic approach to leftist politics; one that paid equal attention to the fight for gender and sexual rights, the liberation of workers, and the protection of the environment, amongst other principles. Paying close attention to the role that Helem played in shaping the Assembly’s political orientation, the paper traces what drew feminist and queer activists in the early 2000s to leftist political organizing, and what later encouraged many of them to abandon an approach to gender and sexual rights grounded in a broader leftist framework in favor of NGO work. The paper draws on two years of ethnographic fieldwork carried out between 2016 and 2018 among radical leftists in Beirut, as well as in depth life history interviews carried out in the summer of 2019.