Introduction <p>LGBTQ + people in Colombia experience longstanding structural inequalities that shape their health across the life course, yet empirical evidence from the Global South remains limited. This study draws on the Health Equity Promotion Model to examine how COVID-19–related social conditions are associated with self-reported physical health and quality of life among LGBTQ + adults in Colombia, and whether these associations vary by age.</p> Methods <p>Data come from the Colombian subsample (<i>n</i> = 158) of the 2022 Global Pride Study, an online cross-sectional survey of LGBTQ + adults. Measures included frequent poor physical health, a single-item quality of life rating, and pandemic-related changes in work hours, household and non-household relationship quality, ability to meet basic needs, housing stability, and perceived discrimination. Linear regression models and age-centered interaction terms were estimated.</p> Results <p>Employment stability (same or more work hours) was associated with fewer days of poor physical health, and being about the same or more able to meet basic needs was associated with higher quality of life. Experiencing the same or less unfair treatment since COVID-19 was also linked to higher quality of life. Age-stratified interaction models revealed counterintuitive patterns: among older adults, maintaining or improving relationships outside the household and reporting stable or improved housing were associated with more days of poor physical health, whereas these factors were not significantly related to physical health among younger adults.</p> Conclusions <p>Findings highlight how material conditions, relational environments, and age-related trajectories intersect to shape health among LGBTQ + adults in Colombia. Apparent stability in employment, housing, or relationships does not fully offset the cumulative health consequences of lifelong marginalization, particularly for older LGBTQ + people.</p> Policy Implications <p>Systematically incorporating sexual orientation and gender identity measures into Colombian health information systems is essential to monitor disparities and guide resource allocation. Policies should strengthen LGBTQ+-affirming employment protections, housing security, and family- and community-based support, with targeted initiatives for older and transgender adults. Adopting a life-course, equity-oriented approach in public health and social policy is critical to mitigating the long-term effects of structural exclusion on LGBTQ + health and quality of life. Keywords: Quality of Life, Physical Health, Age, LGBTQ +, Colombia</p>