This study investigates the perspectives of service providers working with Chinese lesbian, gay and bisexual (LGB) young people in Hong Kong secondary schools and maps the relationships between same-sex sexualities, religion, education and self-harm. Sixteen service providers, including secondary school teachers, social workers based on and off school sites, and lesbian/transgender activists working in non-governmental organisations serving the LGB and transgender communities, participated in in-depth qualitative interviews. In addition, extensive participant observation was carried out. A grounded theory approach was adopted to code the data, as themes emerged with each successive round of coding. Study findings highlight four main themes: barriers to discussing sexuality at school, the effects of personal disinclination and religion, lesbian and gay youth being perceived as especially susceptible to self-harm, and the similarities in professionals' perceptions of self-harmers and LGB youth. Findings suggest that conservative religious beliefs at both the personal and structural levels act as deterrents to providing counselling and mental health services supportive of LGB youth in Hong Kong.