Abstract As consistently shown across studies from various parts of the world, sexual minority individuals (e.g., those identifying as lesbian, gay, and bisexual [LGB]) are significantly at a higher risk for depression, anxiety, and suicidal thoughts and behavior when compared to heterosexuals. The increased risk for poor mental health among sexual minority populations is believed to be a consequence of LGB individuals’ increased exposure to specific social stressors related to navigating a stigmatized minority identity. Studies trying to explain health inequalities based on sexual orientation have mainly focused on so-called minority stress processes, such as discrimination, internalized homophobia, expectations of rejection, and stress of concealing one’s sexual orientation. This workshop will give examples of studies from various European countries on mental health predictors and trajectories by using various approaches such as population-based sampling, longitudinal data collection, and comprehensive theoretical frameworks. Dr. Gemma Lewis (University College London, UK) will present results showing that sexual orientation-based disparities in mental health are present already in early adolescence and increase throughout the school years. Arjan van der Star (Karolinska Institutet, Sweden) will present population-based data suggesting that openness about sexual orientation is not directly linked to lower risk of depression among sexual minorities, but is instead dependent on access to social support. Conor Mahon (Dublin City University, Ireland) will present results showing minority stressors as predictors of social anxiety among sexual minority men. Associate professor John Pachankis (Yale University, USA) will present results showing that, in addition to increased exposure to social stressors, barriers to societal integration can partially explain the elevated risk of suicidality among sexual minorities. Key messages Sexual minorities are a higher risk of mental health problems, such as depression, social anxiety, and suicidality, as compared to heterosexuals and these disparities can be identified early in life. Sexual orientation-based mental health disparities seem to be based both on disproportionate stigma-related stress and a higher prevalence of general risk factors for poor mental health.