Gay, lesbian, bisexual, and transgender (GLBT) individuals report lower levels of positive mental health than the general population (e.g., Cochran, 2001) and thus have a need for appropriate mental health services. The authors conducted an online survey to assess factors associated with the use of such services and the perceived availability of GLBT-affirmative providers. Of the 226 respondents, 18% reported that they had no insurance coverage; 24% of participants in the sample reported experiencing a mental health concern in the past year for which they felt they needed but did not seek treatment.  Logistic regression analyses indicated that gender, depression, internalized homophobia, medical mistrust, and whether the individual had a choice of affirmative provider predicted the likelihood of participants seeking mental health treatment in the past year. This article discusses social and educational policy implications of these findings.