This qualitative study aims to: 1) acquire an in-depth understanding of perspectives of LGBTQ+ individuals coming from a Seventh-day Adventist background and, by extension, other strict religions; 2) understand the emotional, social, and spiritual challenges as LGBTQ+ process the Seventh-day Adventist church’s rejection of their sexual orientation, their gender identity, and ultimately them as people; 3) identify what has been helpful for LGBTQ+ people in the process of reconciling their sexual orientation and gender identity with their spiritual and religious background; and finally 4) collect data to inform mental health and other practitioners willing to become more culturally competent to work with LGBTQ+ individuals who come from conservative and fundamentalist religious backgrounds. A purposeful sample of 14 participants responded to an online questionnaire of 19 multiple-choice questions. After that, using an in-depth semi-structured approach interview, the researcher conducted an individual 60-90-minute online interview. The interviews were carried out via teleconference method using Zoom and were recorded, transcribed, and analyzed. The participants’ narratives highlighted seven major themes: 1) Affiliation with the Seventh-day Adventist Church; 2) coming out process; 3) mental health issues; 4) self-accepting process; 5) loneliness; 6) spirituality; 7) support groups. All participants shared going through a period of struggle to reconcile their sexual orientation and/or gender identity with their Seventh-day Adventist religious background. While many coming out experiences are difficult, doing so in a strict religion and with adhering parents made their coming out experience unique. The findings of this study showed that high levels of distress, depression, and anxiety were experienced and suggested that the process of identity reconciliation can be extended for some people, and some individuals may need mental health and social support. Feelings of confusion, betrayal, depression, anxiety, fear, and shame were experienced by most participants. Many found support in an on-line website of Adventists who sexually do not comply with their faith. Such websites open the gate of isolation and enabled many to find friends and supporters. LGBTQ+ individuals from the conservative and fundamentalist Seventh-day Adventist Church struggle emotionally, socially, and spiritually to reconcile their sexual orientation and gender identity with their religious and spiritual background. The impact of that experience can cause severe damage, putting the clients' well-being at risk. Mental health providers need to be mindful of the depth of this experience and its consequences. These providers must be culturally competent in both the queer and the religious background to provide adequate support to their clients to avoid further traumatization, loneliness, and hopelessness increase.