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Lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ+) young people are overrepresented in out-of-home social care and face significant physical health, mental health and well-being inequalities compared with their non-LGBTQ+ peers. Their residential care experiences have been missing from the knowledge base, with no prior in-depth published research in the UK. Theoretically informed by an intersectional minority stress framework and combining qualitative and co-production methodologies, this study produced a nuanced understanding of the residential care experiences of LGBTQ+ young people. We interviewed twenty young people (sixteen–twenty-four years old) in England with a broad range of LGBTQ+ and multiple intersecting minority identities. We analysed data using reflexive thematic analysis, producing four themes: widespread discrimination and marginalisation; unmet mental and sexual health needs; importance of affirming professional relationships and resilience and self-relying strategies. Findings suggest that multiple minority identities magnified young people’s challenges. Combining the findings with our systematic scoping review developed an explanatory model which provides a dynamic understanding of (un)supportive or (dis)affirming residential care environments. Implications for policy, practice and research include LGBTQ+ inclusive policies and services, mandatory competency-based training combined with ongoing reflexive supervisory practice and incorporating the voices of LGBTQ+ young people in service delivery.