This study examines whether and how parenthood status is associated with two key aspects of health-mental well-being and smoking-among sexual minority adults across three gender identity groups: cisgender gay men, cisgender lesbian women, and transgender gay/lesbian adults. Background: Parents tend to report worse health than nonparents due to elevated stress associated with parenting. However, most existing scholarship de facto examines parental status and health among cisgender heterosexual adults. Little research has employed an intersectional approach to focus on parenthood and health differences within sexual minority adults across varying gender identities. Method: Ordinary least squares (OLS) and logistic regression models were used to analyze data from the 2010 Social Justice Sexuality Project (N = 2803), a survey of racially diverse sexual and gender minority adults residing in all 50 US states and Puerto Rico. Results: In a sample composed predominantly of people of color, parenthood status is related to both mental wellbeing and smoking status among gay and lesbian adults, but this relationship is inconsistent across cisgender and transgender groups. OLS regression models show that parenthood is positively related to mental well-being among gay and lesbian transgender people, whereas logistic regression results find that parenthood is associated with higher odds of smoking among cisgender gay men.