--- - |2+ Abstract Objective The objective of the study is to assess dyadic stress among sexual minority cancer survivor and caregivers compared to heterosexual cancer survivors and their caregivers. Methods We recruited 167 survivors of nonmetastatic breast cancer of different sexual orientations and their caregivers, who were interviewed via telephone after obtaining consent. We used inverse propensity score weighting to account for differences by sexual orientation in age and length of the survivor‐caregiver relationship and simultaneous equation models consistent with the needs for analyzing dyadic data. Results Survivors and caregivers reported stress levels consistent with population norms, irrespective of survivors' sexual orientation. Accounting for covariates, survivors' and caregivers' stress did not mutually influence one another overall. However, differences by sexual orientation were noted such that caregivers' stress was influential for sexual minority survivors' stress, but not for heterosexual survivors' stress. Conclusions Careful consideration should be given to caregivers of sexual minority survivors, an underserved group for whom currently no interventions exist. - Psycho-Oncology, Volume 27, Issue 10, Page 2389-2397, October 2018.