Using data from Wave II of the National Longitudinal Study of Adolescent Health (Add Health; Bearman, P. S., Jones, J., and Udry, J. R. http://www.cpc.unc.edu/projects/addhealth/design.html, 1997), we conducted multivariate analyses to examine three indicators of psychosocial adjustment (school belonging, self-esteem, depressive symptoms) and their associations with sexual attraction status, sex, and urbanicity. In general, sexual minority adolescents reported lower psychological adjustment than adolescents endorsing other-sex attractions only, with sexual minority females at particular risk. Further, differential patterns of risk for sexual minority youth emerged across rural, urban, and suburban communities. We conclude by discussing implications of these findings for addressing the psychosocial needs of sexual minority adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved)