Table 2.

Qualitative and mixed methods studies included in review (n = 8)

Citation	Type of cancer	Sample size	Sample characteristics	Definition of sexual minority	Definition of caregiver/ partner	Study design/analysis	Study domains	Findings
Boehmer, Linde, & Freund, 2007. Breast reconstruction following mastectomy for breast cancer: The decisions of sexual minority women. Plastic & Reconstructive Surgery, 119, 464-472.	Breast Not metastatic or recurrent; underwent mastectomy	15 sexual minority women who were patients; 12 support people	Patients who did not undergo reconstruction: Mean age 51, 100% white, mean income for one person $57,857 Patients who underwent reconstruction: Mean age 47, 88% white, mean income for one person $52,000, mean income for more than one person $41,667 Caregivers for women without reconstruction: Mean age 49, 75% white, mean income for one person $73,333, mean income for more than one person $55,000 Caregivers for women with reconstruction: Mean age 50, 88% white, mean income for one person $44,167, mean income for more than one person $100,000	Women who reported being lesbian or bisexual or partnering with women	“Trusted other”: “most important support person with respect to their cancer care… other than their treating physician” (p. 465).	Qualitative interview Dyadic Descriptive statistics and grounded theory	Body image, support and satisfaction with reconstruction decision, partner's feeling about decision, impact on relationship	Support people provided decision-making support about whether to undergo reconstruction. Partners were more involved in the process than other support people; they found out more details and expressed more preferences about reconstruction. There was more concordance in decision making among couples in which the patient chose not to have reconstruction.
Bristowe, Hodson, Wee, Almack, Johnson, Daveson, Koffman, McEnhill, & Harding, 2018. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study. Palliative Medicine 32, 23-35.	Any “advanced disease,” including cancer	40 lesbian, gay, bisexual, or transgender people (20 patients, 6 current caregivers, 14 bereaved caregivers); 21 had experience with cancer	Entire sample: 95% white (34 white British, 4 white other); 68% were in their 50s or 60s	Self-identification as lesbian, gay, bisexual, or transgender	Unpaid caregiver	Qualitative interview Not dyadic Inductive thematic analysis	Illness narrative; disclosing identity to health care professionals; partner involvement; support; barriers to care	Participants reported relying on a partner for support during cancer, as well as the isolation that could occur after the death of a partner from cancer. Some patients or partners reported that health care providers did not acknowledge their relationship, and they stated that overt acknowledgement from providers was helpful. Some partners of cancer patients were reluctant to attend support groups unless they were known to be LGBT-friendly, but others said other dimensions of their identity (i.e., age, religion) were more salient.
Brown & McElroy, 2018. Unmet support needs of sexual and gender minority breast cancer survivors. Supportive Care in Cancer, 26, 1189-1196.	Breast	67 sexual minority breast cancer survivors	Full sample: 75% 45 or older; 91% white	Lesbian, gay, bisexual, transgender, or queer	Partner	Cross-sectional internet survey Not dyadic Mixed methods: bivariate analysis of quantitative data and thematic analysis of open-ended responses	Impact of breast cancer on life and relationships	58% were in an intimate partnership at the time of survey administration. 40% of respondents reported their sexual or gender identity mattered as far as getting support for them and their partner. In open-ended responses, many said they thought disclosing their status/relationship to care providers was helpful; it increased trust and reduced stress. Participants reported that treatment had an effect on sexuality and intimate partnerships, with treatment reducing sex drive.
Fish, Williamson, & Brown, 2019. Disclosure in lesbian, gay and bisexual cancer care: Towards a salutogenic healthcare environment. BMC Cancer, 19, 678.	Any cancer Diagnosed within the past 5 years	30 lesbian, gay, or bisexual participants (including 12 SMW, 9 of whom had breast cancer)	Age range: 24-65+; none were from Black or Minority Ethnic communities	Lesbian or bisexual	Partner	Qualitative interview Not dyadic Thematic analysis	Lesbian, gay, and bisexual people's experiences of disclosure and nondisclosure in health care settings, interactions with health professionals, perceptions of cancer care	Partners of cancer patients are a salutogenic resource that medical staff can leverage as long as they are comfortable with the relationship. Sometimes fear of being outed can prevent patients from drawing on partner support in medical settings.
Matthews, Peterman, Delaney, Menard, & Brandenburg, 2002. A qualitative exploration of the experiences of lesbian and heterosexual patients with breast cancer. Oncology Nursing Forum, 29, 1455-62.	Breast	13 lesbian women and 28 heterosexual women (HSW) with breast cancer	Lesbian women: Mean age 51, 85% white, 61% with household income over $50,000	Self-identification as a lesbian	Partner; also “someone to assist me with coping with my illness” and “someone to accompany me to my medical appointments” (p. 1457)	Focus groups plus a self-report survey Not dyadic Descriptive statistics, thematic analysis and representative case study methods	Attitudes about medical decision making, cancer supportive services, satisfaction with health care, use of alternative/complementary therapies,	All lesbians reported having someone to assist them in coping (as did 96% of HSW), and 69% reported having someone available to attend medical appointments with them (compared to 46% of HSW). Of the 5 lesbian women in long-term relationships, 4 were satisfied with the emotional support their partner received from medical providers, and all were satisfied with the inclusion of their partner in medical decisions. In focus groups of both lesbians and HSW, partners were most frequently mentioned as a source of support. Lesbian women reported medical staff treated partners respectfully.
Paul, Pitagora, Brown, Tworecke, & Rubin, 2014. Support needs and resources of sexual minority women with breast cancer. Psycho-Onology, 23, 578-584.	Breast Underwent mastectomy	13 sexual minority women with breast cancer	Mean age 44, 92% white, median family income $70,000-89,999	Self-identification as lesbian, bisexual, gay, or queer	Partner	Qualitative interview Not dyadic Thematic analysis	Decision making after breast reconstruction; support needs and concerns	54% were in long-term relationships at the time of the study. Partnered women noted difficulty finding support groups for female partners; general support groups might not feel safe or appropriate. Seven people noted relationships were disrupted or dissolved by cancer. Young single women were more likely to rely on parents as their main support. Single, middle-aged women had less support overall. Some sought support from former partners. Some partners were very supportive and helped patients adjust to post-treatment bodies and acted as advocates in medical contexts.
Sinding, Grassau, & Barnoff, 2007. Community support, community values: The experiences of lesbians diagnosed with cancer. Women and Health, 44, 59-79.	Breast or gynecologic	23 lesbian women (22 breast cancer, 3 gynecologic cancer, 1 both)	Entire sample: Mean age 50, majority white/European descent, 65% household income < $70,000 Canadian	Self-identification as a lesbian (women whose “primary emotional and sexual relationships are with women,” p. 62)	Partner	Qualitative interview Not dyadic Participatory action research; grounded theory techniques	Cancer experiences; support of partners, friends, and broader lesbian community	Women reported receiving support from partners; some believed lesbians had more support than HSW. Some reported that because their partners were women, they were empathic and understanding. A smaller number reported not receiving adequate emotional support or communication from partners. The fact that participants and partners were the same gender was seen as helpful in some ways (“My partner has ovaries. My partner has a uterus. My partner could be in my position” [p. 67]) but unhelpful in others (i.e., having similar bodies may make partners acutely aware of the changes patients go through). Although some women believed mastectomy was not as problematic for lesbians because their partners did not value breasts as much as male partners did, at least one woman reported she did not find that to be true in sexual encounters after her surgery.
White, & Boehmer, 2012. Long-term breast cancer survivors’ perceptions of support from female partners: an exploratory study. Oncology Nursing Forum, 39, 210-217.	Breast Not metastatic	15 sexual minority women	Mean age 52, 87% white	Self-identification as lesbian or bisexual, or preference for a female partner	Partner	Qualitative interview Not dyadic Thematic analysis	Effects of cancer on women’s lives; cancer-related coping; sources and types of social support	Main themes: 1) Female partners were the primary source of social support; 2) Partners helped survivors manage health and distress; 3) Partners were often perceived as being distressed themselves; 4) Partners contributed in tangible ways (cooking, child care, other housework); 5) Partners were perceived as experiencing burdens of caregiving; 6) Partners provided support by helping survivors have lives that are “pleasurable, forward-looking, and otherwise not centered on breast cancer” (p. 214)