This chapter outlines alternative sexual orientations and genders. These diverse ways and forms of being are often marginalized and denigrated, thereby making these groups and communities vulnerable to trauma and various mental health issues. Additionally, the chapter will briefly explore the historical antecedents of sexuality, gender, and relationships in the Jamaican society while reviewing the local research that has mapped the behaviours of the communities and the society’s treatment of these community members and the resultant impact on their mental health. Particular focus will be placed on the LGBTQ+ and the growing polyamorous community in Jamaica. Highlighting the work of organizations and groups in our Jamaican space, the chapter aims to highlight the current situation in Jamaica, the history and role of advocacy through Jamaican organizations such as JFLAG/Equality for All, TransWave Jamaica, and WeChange Jamaica and finally to map the future landscape of Jamaican mental health with marginalized groups. As the concept of a Caribbean psychology continues to grow and expand in the region and internationally, approaches need to seek to honour and revere indigenous practices and weave them into interventions while seeking to achieve the highest ethical standards of equity, diversity, and inclusivity.