Sexual and gender minority (SGM) people are increasingly becoming parents. To examine the relationship between social determinants of health (SDOH) and health care access among SGM parents, we used 2018-2019 prospective cohort data from The PRIDE Study. We compared health care access between 555 SGM parents and 555 age-matched SGM non-parents. We then used modified Poisson regression to assess the association between SDOH at baseline and health care access at one-year follow-up among SGM parents. We found that SGM parents and SGM non-parents reported differences in SGM identity disclosure to health care providers and health care utilization. SGM parents were less likely than SGM non-parents to disclose SGM identity to health care providers (p < 0.001) and reported more health care avoidance (p = 0.021). Among SGM parents, greater SGM identity concealment (aRR 1.13, 95% CI 1.05-1.22) and increased social isolation (aRR 1.06, 95% CI 1.01-1.10) predicted increased health care avoidance attributed to fear of disrespect or mistreatment. Increased social isolation (aRR 1.05, 95% CI 1.01-1.09) also predicted increased all-cause delayed health care access. Among SGM parents, these proxy measures of interpersonal-level and community-level SDOH suggested risk and protective factors influencing health care access.