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Suicide is a serious public health crisis, and lesbian, gay, bisexual, and transgender (LGBT) adults are at particularly high risk. The present study examined risk factors for mortality by suicide and other causes in LGBT versus non-LGBT middle-aged and older adult veterans who used Veterans Affairs health care services between 2009 and 2019 (n = 834,774). We hypothesized that LGBT veterans (n = 167,676) would be at increased risk of premature mortality from suicide, overdose, and other causes of death compared with non-LGBT veterans (n = 667,774), due to minority stress as measured by proxy risk factors of health and social determinants of health. In bivariate models, LGBT veterans had significantly higher rates of death by suicide and overdose compared with non-LGBT veterans. After controlling for proxy risk factors of minority stress in multivariate analyses, the risk associated with LGBT status was nonsignificant. Sociodemographic variables (e.g., race/ethnicity, age), mental health diagnoses, substance use, and other risk factors contributed significantly to differences in risk. Findings highlight the critical importance of interventions (e.g., U.S. Department of Veterans Affairs Whole Health) for LGBT veterans to manage multiple health risk factors that contribute to mortality risk. Suicide prevention is crucial, especially for middle-aged, older adult, and LGBT veterans. Initiating targeted suicide prevention earlier in life may prevent suicide deaths. Findings also implicate subgroups of veterans who may particularly benefit from systematic improvements to health care delivery. (PsycInfo Database Record (c) 2026 APA, all rights reserved).