The aim of this study was to identify the factors associated with adjustment to breast cancer among sexual minority women with breast cancer and their support person.In a cross-sectional study, sexual minority women with breast cancer and their support provider were asked to self-report social support, distress, and coping, using standardized measures.Twenty-three (77%) women had a support provider participating in the study. Disclosure of sexual orientation, less helpless-hopeless coping, and support provider perception of high fighting spirit were related to lower patient distress. Lower support provider distress was related to more patient disclosure of sexual orientation, a larger social network, and an underestimation of fatalistic patient coping. An overestimation of patients' anxious preoccupation coping was linked to higher support provider distress.Providing opportunities to sexual minority patients and their support providers to focus on issues such as disclosure of sexual orientation and coping may lower patient and support provider distress.