Health geography emphasizes the critical role of place in shaping health outcomes, yet limited research examines how the sociopolitical climate at the local level influences health disparities among sexual minorities. This study investigates the association between socially progressive environments and acute healthcare utilization for suicide-related behaviors and substance use among lesbian, gay, and bisexual (LGB) populations in Ontario, Canada. Using linked administrative health data (2009–2017), we analyzed a cohort of LGB individuals and assessed whether residing in communities with greater electoral support for the socially progressive New Democratic Party (NDP) was associated with reduced risk of these adverse health outcomes. Findings indicate that a 1% increase in NDP vote share was associated with a 1.5% reduction in suicide-related events and a 6.2% reduction in substance use-related hospitalizations and deaths. Gender-stratified analyses revealed that the protective effects of progressive environments were more pronounced among women. These findings highlight the significance of political geography in shaping health inequities and suggest that community-level social climates play a crucial role in mitigating the impacts of minority stress among sexual minorities. As rising anti-LGB sentiments threaten health equity, our study underscores the need for geospatial and policy-driven approaches to safeguarding the well-being of marginalized populations. This work contributes to health geography by demonstrating how place-based sociopolitical factors shape mental health outcomes, reinforcing the necessity of intersectional and geographically nuanced public health interventions.