Lesbians, gays, bisexuals, and transgender individuals have persistent obstacles pertaining to their sexual orientation and gender identity, including but not limited to discrimination, prejudice, assault, limited access to healthcare, and inadequate social support. The present study investigates whether there are racial-ethnic differences in the physical and mental health (MH) of sexual and gender minorities (SGMs). Data from 28,345 adults who participated in the 2020 Behavioral Risk Factor Surveillance System answered questions regarding sexual orientation (SO), transgender identity (TI), physical health (PH), and MH. SO, and TI were associated with overall general health, acute MH, acute PH, and specific chronic conditions. SO, and TI were associated with acute MH, PH chronic conditions, and overall general health, but not acute PH. Bisexuals had more chronic conditions than heterosexuals and worse acute MH than heterosexuals. SO, and TI strongly predicted acute PH and MH status respectively. These findings can assist healthcare providers in developing strategies to reduce health disparities among SGMs.