Cancer care experiences among sexual and gender minority adults: A qualitative descriptive study.

e13731 Background: Sexual and gender minority (SGM) individuals experience disparities across cancer screening, treatment, and survivorship, yet patient-centered data describing SGM experiences and preferences for affirming care remain limited. We explored cancer care experiences among SGM adults, including partner involvement, sexual health, and perceptions of affirming care across the cancer care continuum. Methods: We conducted a qualitative descriptive study using purposive and snowball sampling through an academic oncology program and an SGM support group in the urban Northeastern United States. Adults identifying as SGM with a history of invasive cancer completed a demographic survey and semi-structured telephone interview. Interviews were audio-recorded, transcribed verbatim, and analyzed inductively. Multiple investigators independently coded transcripts and developed themes through consensus. Results: Fifteen SGM participants were interviewed (10 lesbian women, 1 bisexual woman, 3 gay men, 1 transgender man). Mean age at diagnosis was 51.8 years (range 35–81). Diagnoses included breast (n = 11), prostate (n = 2), renal cell carcinoma (n = 1), and central nervous system lymphoma (n = 1). Four themes emerged. First, cancer detection often occurred through self- or partner-detection rather than routine screening, including one breast cancer identified incidentally following gender-affirming chest surgery. Second, partners played central roles in emotional support, advocacy, and healthcare navigation, though misidentification or limited acknowledgment occurred in clinical settings. Third, participants described treatment-related sexual health impacts, including substantial changes in libido, intimacy, and sexual functioning, with limited anticipatory counseling. Fourth, the perceived importance of affirming care varied across the care continuum, with clinical expertise prioritized during diagnosis and treatment, and affirming communication and SGM cultural competence increasingly valued during follow-up and survivorship. Conclusions: SGM patients prioritized high-quality oncologic care during initial treatment. Over time, affirming communication, partner inclusion, and attention to sexual health became increasingly important. Interventions promoting inclusive communication and routine sexual health discussions may improve equity in SGM cancer care. In regions with larger SGM populations, these findings suggest that specialized programs may be a feasible approach to delivering more inclusive and affirming care.