Contemporary heterosexism includes both overt and subtle discrimination. Minority stress theory posits that heterosexism puts sexual minorities at risk for psychological distress and other negative outcomes. Research, however, tends to focus only on 1 form at a time, with minimal attention being given to subtle heterosexism. Further, little is known about the connection between minority stressors and underlying psychological mechanisms that might shape mental health outcomes. Among a convenience sample of lesbian, gay, bisexual, and queer (LGBQ) college students (n = 299), we investigated the role of blatant victimization and LGBQ microaggressions, both together and separately, on psychological distress and the mediating role of self-acceptance. We conducted structural equation modeling to examine hypothesized relationships. Heterosexism was measured as blatant victimization, interpersonal microaggressions, and environmental microaggressions. Self-acceptance included self-esteem and internalized LGBTQ pride. Anxiety and perceived stress comprised the psychological distress factor. Our results suggest that students with greater atypical gender expression experience, greater overall heterosexism and victimization, and younger students experience more overall heterosexism, and undergraduates report more victimization. Microaggressions, particularly environmental microaggressions, are more influential on overall heterosexism than blatant victimization. Overall heterosexism and microaggressions demonstrated main effects with self-acceptance and distress, whereas victimization did not. Self-acceptance mediated the path from discrimination to distress for both overall heterosexism and microaggressions. Our findings advance minority stress theory research by providing a nuanced understanding of the nature of contemporary discrimination and its consequences, as well as illuminating the important role self-acceptance plays as a mediator in the discrimination-psychological distress relationship.