The present study examined the archived results of a national survey involving the perceived role and actual practices of school psychologists working with sexual minority youth. The study focused on identifying factors associated with the perceived role and responsibility of school psychologists when working with this population and subsequent provision of support services. The majority of school psychologists agreed addressing harassment should be a part of their role while only one-third gave such ratings in regard to addressing sexual risks. There was wide variability across differing types of actual services provided. Less than one-quarter of the respondents reported involvement with sexual health related issues and one-quarter had intervened to address harassment of LGBQ youth. Survey responses demonstrated a significant relationship between the amount of services delivered to LGBQ youth by school psychologists and the amount of both formal and professional development training these psychologists received related to LGBQ youth. However, only professional development training was related to perceived role. No relationship between the time elapsed since graduate training and services provided to LGBQ youth was found. Although attitudes about the role and responsibility of the school psychologist in working with LGBQ youth may not have changed, some individuals had the skill base to deliver such services. Clearly, given the literature's emphasis on viewing the school psychologist's role within this comprehensive health care model, it would be imperative to provide professional development and pre-service training in both the role and the skills needed for addressing the multiple needs of sexual minority youth.