The prevalence of suicidality among gay, lesbian, & bisexual youth in North America is considerably higher than reported rates for heterosexual youth. It appears that both groups are vulnerable to similar risk factors, including substance abuse, victimization, social isolation, & familial suicide. However, homosexual & bisexual youth show significantly elevated rates for these risk factors. The strongest predictors for suicidality, unique for sexual minority youth, are gender non-conformity & younger age at time of homosexual identity formation. Religiosity presents another possible risk factor in gay youth suicide. It is concluded that an accumulation of risk factors in combination with few protective factors exacerbate suicidality among homosexual youth.