Sexual and gender minority (SGM) young people are coming of age at a time of dynamic social and political changes with regard to LGBTQ rights and visibility around the world. And yet, contemporary cohorts of SGM youth continue to evidence the same degree of compromised mental health demonstrated by SGM youth of past decades. The authors review the current research on SGM youth mental health, with careful attention to the developmental and contextual characteristics that complicate, support, and thwart mental health for SGM young people. Given a large and rapidly growing body of science in this area, the authors strategically review research that reflects the prevalence of these issues in countries around the world but also concentrate on how mental health concerns among SGM children and youth are shaped by experiences with schools, families, and communities. Promising mental health treatment strategies for this population are reviewed. The chapter ends with a focus on understudied areas in the SGM youth mental health literature, which may offer promising solutions to combat SGM population health disparities and promote mental health among SGM young people during adolescence and as they age across the life course.