AbstractIssues AddressedThere is a paucity of data regarding depression and thoughts of self‐harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap.MethodsThe sample included 91 GSD people from a regional community in South‐West Queensland utilising the PHQ‐9 to determine presence/severity of depression and self‐harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between‐subgroup differences in depression and self‐harm/suicide ideation.ResultsOverall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self‐harm/suicide ideation in the past two‐weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self‐harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups.ConclusionsThese findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self‐harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people.So What?The current findings revealed GSD people experience high prevalence of depression and self‐harm/suicide ideation indicating tailored mental health awareness‐raising, training and health promotion is warranted to enhance psychological support.