This constructivist grounded theory dissertation study investigates Chicago Black gay men’s perceptions and experiences of the city of Chicago’s LGBTQ health infrastructure. The study examines these men’s descriptions and experiences of interpersonal and structural trauma within the context of their lives as well as the myriad challenges that men faced in their LGBTQ health seeking and service utilization experiences. Contrary to prevailing public health discourses, participants reported confronting multiple and intersecting forms of risk, trauma, and marginalization within multiple social domains. The dissertation sought to answer a guiding research question: What are the social and contextual factors that motivate or inhibit LGBTQ health infrastructure access or engagement for Chicago Black gay men ages 18 to 25? Consistent with constructivist grounded theory methodology, the researcher used a multi-method approach. These data collection methods included: (a) in-depth interviews, (b) shadowing, and (c) participant observation. The researcher interviewed 30 Chicago Black gay men who ranged in age from 18 to 25 with prior and/or ongoing involvement with Chicago’s LGBTQ organizations. The researcher shadowed 3 additional Chicago Black gay men who were ages 18 to 25. Finally, the researcher engaged in participant observation at two South Side Chicago LGBTQ organizations for approximately one year to contextualize in-depth interview and shadowing data. This dissertation, as both an empirical investigation and theoretical intervention, develops two grounded theories —intersectional trauma and spatial marginalization. Intersectional trauma addresses the multiple and overlapping forms of trauma that participants reported as motivating their engagement with Chicago LGBTQ organizations. Spatial marginalization, alternatively, organizes and explains spatial characteristics that Black gay men describe that may challenge their abilities to access various LGBTQ organizations. Although the study is limited due its focus on Black gay men who reside in one urban context—i.e., Chicago—and these particular men’s distinct descriptions and experiences of its LGBTQ health infrastructure, the study does the important work of identifying key processes and mechanisms relating to the social and contextual factors that motivate and inhibit access to and engagement with LGBTQ health infrastructure for marginalized racial, gender, and sexual minority populations.