In recent years, local governments and communities in Utah have begun discussing ways sexual/gender minority youth may experience particularly high levels of negative mental health symptoms, stigma, bullying, and family rejection. Using the Psychological Mediation Framework (PMF), we examined if being bullied due to sexual orientation or gender identity was associated with self-harm, internalizing symptoms, substance misuse, suicide risk, and academic achievement through social, cognitive, and emotional processes. To test this hypothesis, we ran a path analysis on a large representative sample of sexual/gender minority middle and high school students in Utah (N = 6909). Results demonstrated general support for the proposed pathways, with 51% to 78% of the effects of being bullied onto the negative outcomes being mediated by the social, cognitive, and emotional processes. The need for more anti-bullying policies and targeted psychological treatments for sexual/gender minority youth in Utah is discussed.