Objective: The authors sought to determine whether Black sexual minority individuals were more likely than White sexual minority individuals to postpone or avoid professional mental health care (PMHC) and, if so, to identify the reasons for postponing or avoiding care.

Methods: Analyses were conducted with a subsample of cisgender Black (N=78) and White (N=398) sexual minority individuals from a larger survey of U.S. adults administered via MTurk in 2020 (N=1,012). Logistic regression models were used to identify racial differences in overall postponement or avoidance of care as well as differences in the prevalence of each of nine reasons for postponing or avoiding care.

Results: Black sexual minority individuals were more likely than their White counterparts to report ever postponing or avoiding PMHC (average marginal effect [AME]=13.7 percentage points, 95% CI=5.4–21.9). Black sexual minority people also were more likely than their White counterparts to cite beliefs that they should work out their problems on their own (AME=13.1 percentage points, 95% CI=1.2–24.9) or with family and friends (AME=17.5 percentage points, 95% CI=6.0–29.1) and to cite providers’ refusal to treat them (AME=17.4 percentage points, 95% CI=7.6–27.1) as reasons for postponing or avoiding care.

Conclusions: Black sexual minority individuals were more likely than their White counterparts to report delaying or avoiding PMHC. Personal beliefs about managing mental health and providers’ refusal to offer treatment influenced Black sexual minority individuals’ willingness or ability to seek PMHC.