The purpose of this explanatory, sequential mixed methods research study was to describe the experiences and perceptions of depression, anxiety, and stress (DAS) among those who identify as women and gender minorities (i.e., non-binary, third gender, transgender woman, transgender man) in university music settings. In the current follow-up study, building on prior research, we aimed to explain why students and faculty in university music settings who identify as women and gender minorities report feelings of adverse mental health and advancement obstacles, and to identify possible opportunities for universities to strengthen support of these populations. We employed a two-phase sequential explanatory mixed methods design (Creswell & Clark, 2018), collecting quantitative data first from a large sample and then interviewing a smaller group of individuals to provide a more in-depth explanation of the quantitative results. After obtaining IRB approval, the National Association for Music Education (NAfME) distributed the Depression Anxiety Stress Scale-21 (DASS-21) to a random sample of organization members who identified as collegiate faculty and university students. Altogether, our sample size was n = 512. At the conclusion of the questionnaire, we asked participants to provide their email address if they were willing to participate in a follow-up interview. We received email addresses from 141 participants. Of those, we selected 9 to interview based on their questionnaire responses. We used multiple measures to ensure the study design was valid and reliable before proceeding. Based on responses to the quantitative questionnaire, it appears as though women and gender minorities experience higher levels of DAS than men, particularly related to anxiety, confirming prior research. Those identifying as transgender and “gender not listed,” or other, appear to experience the most severe DAS. These quantitative results established a baseline of perceptions of DAS, as well as informed our interview protocol and participant selection.We collected interview transcripts via closed caption text in Zoom, using an overall inductive and comparative strategy in analysis. We extracted codes from the data based on their potential to answer the research questions established for the study, employing both in vivo and focused coding. We reduced and collapsed codes into categories, then interpreted the categories to generate themes. Themes that emerged included: Intersectionality; Institutional support; Gender-based bias and discrimination; Safety; and Coping strategies. It is important that university music stakeholders continue to address ways in which we can improve teaching and learning for everyone.