Homeless youth who identity as lesbian, gay, bisexual, or queer (LGBTQ) face considerable issues including victimization, mental health needs, and substance use, yet are less likely than their heterosexual homeless peers to utilize services. Although research in this area is growing, studies tend to focus on the experiences and service use of homeless youth in drop-in or emergency shelters, instead of longer-term transitional living programs (TLPs). Therefore, the purpose of this study was to expand the homeless youth literature by examining differences in sociodemographic characteristics, victimization, mental health, and substance use histories, and service utilization patterns of homeless youth by LGBQ identity (LGBQ vs. non-LGBQ) in a TLP. We extracted secondary data from closed case files of homeless youth (N = 101) ages 16–20 who accessed services in a mid-Michigan TLP between 2011 and 2018. Using independent sample t-tests and Chi-square, we assessed patterns by LGBQ. Results indicate that LGBQ homeless youth were more likely than their non-LGBQ homeless peers to identify as female, report being sexually victimized, and have greater mental health-related needs. All youth, but especially LGBQ youth underutilized available services, resulting in greater unmet mental health needs. These findings confirm the vulnerability of LGBQ homeless youth in TLPs and provide essential information regarding service utilization for homeless youth practitioners, including the need for trauma-informed and LGBQ-specific services. Additionally, the data suggest that service providers must encourage youth engagement in services offered within TLPs.