LGBTQIA+ covering lesbian, gay, bisexual, transgender, queer, intersex, asexual under one umbrella term represents a unique community with varying physical and mental health needs. LGBTQ elders have higher levels of psychological distress compared with heterosexual elders in general. They experience multiple barriers stemming from discrimination, social stigma, isolation, lack of equitable health services access, economic insecurity, and a long-term lack of legal and social recognition. Other risk factors that predispose to poor mental health outcomes include violence, small social network, internalized homophobia, and lack of connection to the larger community. Reliance on the chosen family due to family rejection and legalized discrimination instills a feeling of helplessness and enhances vulnerability. Each senior LGBTQ conveys their own account of pride and sorrows, of resilience and grapple, of loss and love. Despite these challenges, many LGBT elders have survived and even thrived, but few gravitate down, so it is necessary to have in place appropriate interventions and supports to effectively meet the needs of this population. This chapter will illustrate how LGBT elders’ quality of life is impacted and offer concrete recommendations to address these specific psychosocial disparities.