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This systematic review evaluated 35 out-of-school (OST) STEM-health education programs through an intersectional lens. Approximately two-thirds of the programs challenged the assumption of neutrality and meritocracy in STEM education by addressing structural inequities. Nearly half prioritized multiply-marginalized groups, 51.3% incorporated culturally responsive programming, and 42% employed transformative practices to contribute to dismantling structural barriers (e.g., empowering Latino youth in community advocacy). Best program practices were discussed in the framework of intersectionality. The findings collectively underscored the dire need for informal STEM-health programs to move beyond surface-level inclusion and actively engage with equity, cultural responsiveness, and systemic transformation in all aspects of a program—mission, target participants, guiding theory, content and implementation, and evaluation.