In the US, nicotine and tobacco use disproportionally affect sexual and gender minority (SGM) populations. Social media narratives may contribute to use disparities. This qualitative study delineated perceptions and experiences depicted in SGM user-generated messaging about e-cigarettes on TikTok. Young adult researchers engaged in every step of the research process, adding an insider perspective. Using four TikTok accounts, we used e-cigarette and SGM-related search terms to sample videos in March-April 2022. Three TikTok accounts collected SGM-specific videos; a fourth provided non-SGM specific videos for comparison. We iteratively sorted 303 unique videos into 32 a priori and emergent codes and identified themes in SGM videos and comparison videos. In the videos, SGM e-cigarette users reflected e-cigarette use as an identity cue and a consideration in romantic partnership, and creators displayed awareness of and apathy toward their e-cigarette use and dependence. Studying video-based social media platforms, like TikTok, through an insider-engaged qualitative lens allows for nuanced understanding of perceptions, attitudes, and motivations for e-cigarette use and other health behaviors, which can inform appropriate interventions for SGM young people.