The study sample consisted of 758 adolescents who presented for mental health intake at the Mount Sinai Adolescent Health Center in New York City, which serves inner-city adolescents, between April 27, 1999, and April 9, 2002. Of these, 36.4 percent were male, and 63.6 percent were female; 5.3 percent of males defined themselves as LGBQ; whereas, 13.3 percent of females identified themselves as such. Of those who identified themselves as LGBQ, 13.8 percent were between the ages of 17 and 21, 10.3 percent were between the ages of 15 and 16, and 7.5 percent were between the ages of 11 and 14. In addition to identifying LGBQ sexual identity, the questionnaire focused on risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these issues in counseling. In most respects, LGBQ adolescents seeking mental health services have the same concerns and needs as straight youth; however, LGBQ youth are generally at higher risk than straight adolescents in the area of safety. They more often report feeling unsafe despite having the lowest levels of violent victimization. This suggests that feeling unsafe may be related to their sense that society in general is hostile toward LGBQ individuals, so they fear disclosure of their sexual identity and the adverse consequences that may follow. An encouraging finding of the study is that LGBQ adolescents have a desire to talk about their health, substance abuse, friends, and personal lives, suggesting that they will be responsive to counseling. Their multiple safety risks indicate that counselors should focus on modifying risky behaviors and attitudes. 5 tables and 17 references