Barriers to participation in formal support groups for sexual and gender minority cancer survivors: A systematic review.

109Background: Within the United States, there are an estimated one million cancer survivors who identify as a sexual and/or gender minority (SGM). However, this population underutilizes cancer support groups despite evidence demonstrating that they increase quality of life and survivorship. The purpose of this systematic review is to identify what barriers prevent participation in formal support groups for SGM cancer survivors. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors conducted a thorough review of 113 studies after searching the databases PubMed, Embase, CINHAL, and Ovid MEDLINE. Studies were included if published from 1/2015-5/2025, written in English, and specifically mentioned or reported on an SGM. Studies were excluded if not data based, if participants were less than eighteen years old, and if the study was completed outside of the United States. Results: Twelve studies were included in this review resulting in a collective sample size of 932 individuals, with a greater representation of sexual minorities (95%, n = 886) compared to gender minorities (9.4%, n = 88). Three of the studies focused on breast cancer (25%), four on prostate cancer (33.3%), and the remaining five included a variety of cancers (41.7%). Four key barriers limiting SGM cancer survivor’s participation in formal support groups were identified: increased heteronormativity or the reinforcement of binary sex and gender roles (36.4% [4/12]), difficulty finding SGM-specific groups (81.8% [9/12]), lack of community or feelings of isolation (45.5% [5/12]), and the absence of cancer centers facilitating tailored support (36.4% [4/12]). Conclusions: The most prevalent challenge was the lack of accessibility of SGM-specific support groups, so providing affirming support services tailored to the unique needs of SGM cancer survivors is pivotal to improve both participation and psychosocial wellbeing. Future research should prioritize representation of gender minority cancer survivors to better address their needs and experiences.