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Objective: To determine factors that influence sexual minority women's coping responses and adjustment to breast cancer.

Methods: We conducted a cross-sectional study with 64 sexual minority women with breast cancer who were recruited through targeted community-based sampling. In this study, sexual minority women consisted of three sexual orientation groups: those who self-reported partnering with women and those with a lesbian or bisexual identity. We determined the number of years of sexual minority status and disclosure of sexual orientation and used standardized measures to assess these women's coping and adjustment to breast cancer. Data were analyzed using statistical methods as appropriate for the level of data.

Results: We determined that sexual minority factors, such as sexual orientation group, influenced coping and adjustment even after illness and social support factors were controlled. In multivariate analyses, women who identified as lesbians or bisexuals used less maladaptive coping compared with women who reported partnering with women. The association between reporting a lesbian identity and lower distress approached significance in multivariate regression equations.

Conclusions: Of the sexual minority factors that were considered, sexual orientation group, number of years of sexual minority status, and disclosure of sexual minority status, only sexual orientation group was related to coping and lower distress. Contrary to expectations, disclosure of sexual orientation did not relate to coping and lower distress. The findings support the need for future studies to include different aspects of sexual minority status, in particular, clearly defined sexual orientation groups.