This report focuses on LGBTQ youth who become involved in the commercial sex market to meet basic survival needs, describing their physical, mental, and sexual health issues, their substance use, and their experiences with service providers. It finds that most youth protect themselves from harm in several ways, including using protection against sexually transmitted infections and pregnancy and visiting service providers for health and nonhealth services. However, most of the youth reported needs that were unmet by service providers, including employment assistance and short- and long-term housing, and youth who reached ages 18 or 21 had even greater challenges accessing services.