Sexual minorities are disproportionately affected by mental health problems (e.g., depression, anxiety, substance use disorders, suicidality). Minority stress theory and the psychological mediation framework have become the predominant conceptual models used to explain these disparities, and they have led to substantial advances in research on stigma-related stress and mental health. However, the field's reliance on these models has limited the extent to which other theories have been considered as potential frameworks for further advancing our understanding of sexual minority mental health. In this article, I discuss how the rejection sensitivity (RS) model can be used to complement and extend minority stress theory and the psychological mediation framework by: (1) emphasizing the role of perception in stigma-related experiences; (2) acknowledging the unique consequences of different anticipatory emotions; (3) describing additional mechanisms linking proximal minority stressors to mental health; and (4) further specifying the temporal order of these processes. I conclude by discussing the importance of attending to developmental processes in research on sexual orientation-related RS and describing important directions for future research.