The goal of this dissertation was to explore aging lesbian and gay individuals living in rural communities, in terms of their social networks and the relationships between these networks, identity, health, and quality of life. Guiding the study were three overarching questions. Using a multi-method design, the research was grounded within a socio-ecological context and focused on how structural systems create pathways for health and are affected by social position (intersectionality). Participants (n=25) were recruited from Kentucky (n=20), West Virginia (n=3), and Tennessee (n=2). Thirteen participants self-identified as gay and twelve as lesbian. Findings highlight the complexity of the aging experience and the difficulty in parsing out the influence of a rural location, the aging process, and being a lesbian or gay male, on social network development, identity, health, and quality of life. Findings indicate that rural gay and lesbian individuals develop networks based on need with limited consideration for network members’ acceptance of their identity. The findings also indicate that networks are primarily composed of heterosexual members. Social isolation and loneliness remain a pervasive issue in the rural gay and lesbian aging community. Finally, network size does not affect the overall health and quality of life for rural aging lesbian and gay individuals, but identity congruence does. Conclusions point to the greater need for research to understand the factors affecting aging lesbian and gay individuals in rural environments. Opportunities abound for developing further research addressing social isolation among this population and exploring the positive relationship between identity congruence and quality of life. The findings highlight the collective need to continue research into sexual minority aging and rural sexual minority aging.