Despite the sociolegal changes that have signalled greater acceptance of sexual diversity and gender expansive identities in the twenty-first century, worldwide studies highlight the increased risk of mental health problems and suicidality for those with a sexual and/or gender minority status. This chapter discusses this increased risk of suicidality among sexual and gender minority populations across the life course. A recurring theme is that those who are less sure of their status, are most at risk. Therefore, the capacity of an individual to overcome internalized minority stress, stigma, guilt, and shame, and to reconcile, even take pride, in their sexual/gender status, is a significant issue. While sociolegal, cultural, and familial norms may seem beyond the remit of mental health professionals, affirmative and inclusive actions can be taken to support questioning youth, unsure adults, and distrustful older people, and to help improve the resilience and well-being of their LGBTQ+ service-users.