This cross-sectional study examines which aspects of sexual, gender, and religious/spiritual (R/S) identities predict R/S struggles and life satisfaction among sexual minority adults. A large, nonprobability sample (N = 644; Mage = 35.16, 84.0% American; 15.2% of the sample were also transgender/gender-nonconforming persons) completed measures asking about their sexual orientation identity and sociodemographics, current and childhood religiousness/spirituality, and current R/S struggles and life satisfaction. Participants reported typical levels of life satisfaction but disproportionately high rates of overall R/S struggles and most R/S-struggles subtypes, particularly interpersonal struggles. Sexual minorities who were raised Christian reported higher overall, interpersonal, and doubt-related R/S struggles during adulthood than those who were not raised Christian. Sexual minority adults who were currently Christian-affiliated (vs. not) reported higher levels of all R/S-struggle subtypes except interpersonal struggles. However, sexual minority adults evidenced no differences in life satisfaction based on whether they were raised Christian (vs. not) or had a current Christian affiliation (vs. not). R/S factors (especially a current Christian affiliation and childhood or current involvement in a R/S community participants perceived as less lesbian, gay, bisexual, and queer+ [LGBQ+] affirming) predicted sexual minorities’ R/S struggles beyond the influence of demographics but did not predict additional variance in life satisfaction. Sexual-orientation identity factors (particularly higher levels of integration and outness) uniquely predicted lower R/S struggles and higher life satisfaction. Results highlight a need for research on how multilevel stigma intersects with sexual, gender, and R/S identity development. Interventions that target R/S struggles, identity integration, and identity-affirming R/S support are also needed.