The current study examined potential mediators (i.e., internalized heterosexism and religious struggle), moderators (i.e., religiosity), and moderated mediation of the links between experiences of enacted religious-based sexual stigma and both psychological distress and wellbeing. Participants were 193 lesbian, gay, and bisexual (LGB) persons who were currently affiliated with a faith/religion and who completed an online survey. Participants were recruited through paid Facebook advertisements and research announcements sent to a variety of LGB-related Listservs, organizations, and Internet resources. Results from the mediation analyses revealed that religious-based sexual stigma was indirectly related to more psychological distress and less wellbeing via more internalized heterosexism and greater religious struggle. Findings from the moderated-mediation analyses revealed a significant conditional indirect effect, in which the indirect effects of religious-based sexual stigma on both psychological distress and wellbeing via internalized stigma were significant at moderate and high, but not low, levels of religiosity. This finding suggests that lower religiosity plays a buffering or protective role, whereas higher religiosity plays an intensifying role. The results of this study underscore the importance of targeting enacted and internalized sexual stigma-related stressors and religiosity factors to improve the psychological health of religiously identified LGB persons.