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Purpose: Sexual and gender minority (SGM) cancer survivors have poorer psychosocial health than their heterosexual cisgender counterparts. Nevertheless, most research has focused on breast and prostate survivors. It is unknown how different gastrointestinal (GI) cancers affect the psychosocial well-being of SGM individuals. We (1) described the psychosocial health of SGM people with GI cancers and (2) identified differences in psychosocial health outcomes by cancer type., Methods: We conducted a concurrent mixed-methods secondary analysis with identical samples (n = 295) using data from "OUT: The National Cancer Survey." Likert-type and open-ended questions about demographics, satisfaction with care, social support, and access to mental health resources were included in the analysis. Poor mental health was the primary outcome. Quantitative (linear regression) and qualitative (thematic analysis) data were independently analyzed, then integrated through the narrative, weaving approach., Results: Three concepts emerged after data integration, (1) positive and negative influences on the psychological well-being of the participants; (2) social adaptations with the participants' friends, partners, and family members; and (3) additional factors affecting the psychosocial well-being during and after cancer, particularly interactions with providers, comorbidities, and treatment side effects., Conclusion: Clinical characteristics, demographic factors, and culturally responsive care influenced the psychosocial health of SGM survivors of GI cancers., Implications for Cancer Survivors: Participants developed their own coping strategies and advocated for the SGM community. Interventions promoting peer support and self-esteem are a priority for this population. Healthcare professional training should incorporate historical trauma awareness and assess the delivery of culturally responsive care., (© 2024. The Author(s).)