In this paper, we review developmental models for understanding adolescence as they might be applied to emerging sexuality and the challenges and risks that may be associated with different sexual orientations and identities. Models have been identified as: cumulative events or simultaneous change, accentuation, or trajectory models. Inclusion of risk and protective factors and considering the extent of balance between these elements of an adolescent's life is also discussed in terms of predicting mental health outcomes. These models have been particularly useful in the study of the development of psychopathology and clearly relate to the broader issue of understanding suicide risk during adolescence.