Few sexual health studies have examined subgroup differences in youth risk behaviors that sufficiently account for sexual orientation and gender identity. This study used 2017 New York City Youth Risk Behavior Survey data (N = 10,191), a stratified cluster-sampled survey, to examine descriptive differences in the prevalence of risky sexual behaviors, such as failing to use contraception and engaging in sexual activity while intoxicated, among others. Weighted logistic regression analyses revealed that LGBTQ youth were more likely to engage in risky sexual behaviors than non-LGBTQ youth, placing them at increased risk of pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV). Results suggest the need for prevention and intervention programs, and more fundamentally, basic health education and care for these adolescents whose risk for sexual and reproductive health concerns outweighs their non-LGBTQ peers.