This article aims to highlight the scope of community-led interventions in LGBTQI+ mental health promotion, and to emphasize the importance of analyzing tensions between community health and public health policies. Sexual and gender minorities represent populations that are particularly vulnerable to psychological distress, while simultaneously being hesitant to seek out healthcare services due to fears of stigma or inadequate support. Faced with this reality, LGBTQI+ communities have historically come together to develop community-led peer support tools tailored to their specific needs, despite limited material resources and a hostile international political context. By operating at the forefront of these challenges, they serve as essential intermediaries in identifying mental health issues among LGBTQI+ populations, establishing foundational solutions, and driving systemic improvements through partnerships with healthcare professionals and institutions. However, the vulnerability of grassroots organizations can lead to exhaustion and burnout among its actors, who often lack formal training in mental health matters. The article concludes that public mental health policies must actively incorporate and financially support LGBTQI+ community- led interventions to develop culturally appropriate and socially equitable responses, as these local initiatives represent a critical gateway to public mental healthcare services.