We collected and analyzed Instagram direct messages (DMs) from 173 youth aged 13-21 (including 86 LGBTQ+ youth). We examined youth's risk-flagged social media trace data with their self-reported mental health outcomes to examine how the differing online experiences of LGBTQ+ youth compare with their heterosexual counterparts. We found that LGBTQ+ youth experienced significantly more high-risk online interactions compared to heterosexual youth.LGBTQ+ youth reported overall poorer mental health, with online harassment specifically amplifying Self-Harm and Injury. LGBTQ+ youth's mental well-being linked positively to sexual messages, unlike heterosexual youth. Qualitatively, we found that most of the risk-flagged messages of LGBTQ+ youth were sexually motivated; however, a silver lining was that they sought support for their sexual identity from peers on the platform. The study highlights the importance of tailored online safety and inclusive design for LGBTQ+ youth, with implications for CHI community advancements in fostering a supportive online environments.Content Warning: This research discusses sensitive topics, including explicit sexual content, abusive language, and homophobic slurs, which may cause discomfort. Reader discretion is advised.