<p>Sex and Gender are Not the Same: Why Identity Is Important for People Living with HIV and Chronic Pain</p>

Abstract

Background: Sex differences in pain sensitivity have been well documented, such that women often report greater sensitivity than men. However, clinical reports highlighting sex differences often equate gender and sex. This is a particularly critical oversight for those whose gender identity is different than their genetic sex. Methods: This preliminary study sets to analyze differences in pain responses between cisgender and transgender individuals living with HIV and chronic pain. A total of 51 African-American participants (24 cisgender men, 20 cisgender women, 7 transgender women) with similar socioeconomic status were recruited. Genetic sex, gender identity, depression and anxiety, pain severity, pain interference and pain-related stigma were recorded. Participants also completed a quantitative sensory testing battery to assess pain in response to noxious heat and mechanical stimuli. Results: Transgender women and cisgender women demonstrated a greater magnitude of temporal summation for heat pain stimuli or mechanical stimuli compared to cisgender men. Specifically, transgender women reported greater mechanical summation than either cisgender women or cisgender men. Transgender women and cisgender women similarly reported greater chronic pain severity compared to cisgender men. Conclusion: These data support the notion that gender identity may play a more significant role in pain sensation than genetic sex. These results further maintain that not only gender identity and genetic sex are distinct variables but that treatment should be based on identity as opposed to genetic sex.

Cognitive-Affective Transdiagnostic Factors Associated With Vulnerability to Alcohol and Prescription Opioid Use in the Context of Pain

“…Although the findings presented in the current review may have been drawn from cisgender samples, future research should test associations between pain and substance use among transgender and gender minority populations. 134 , 135 Additionally, despite documented racial/ethnic disparities in the prevalence, treatment, and outcomes of pain-related conditions, 136 , 137 this review identified only one study that examined the current constructs of interest among racial/ethnic minorities. 97 A recent review of racial and ethnic disparities in chronic pain treatment found that Black patients maintained on long-term opioid medication were more closely monitored for misuse, despite higher rates of opioid misuse and opioid-related overdose deaths observed among Whites.…”

Simultaneous Bilateral Ovarian Torsion in a Transgender Patient

“…The patient is a transgender male who visited multiple emergency departments and had a delayed diagnosis possibly due to several reasons. These reasons may include the patient leaving AMA before further evaluation could be performed; the perception of the patient’s pain/clinical picture not matching the “expected” presentation of ovarian torsion; the patient’s unwillingness to endorse true pain level for fear of being gendered [ 9 , 10 ]; and, lastly, the inexperience with this condition in such populations. Cases like this can perhaps be seen as a challenge to all generalizations, as every patient is unique.…”

Making Pain Research More Inclusive: Why and How

“…Similarly, gender is now recognized as existing along a spectrum, yet virtually all pain research continues to operationalize gender as binary, and gender identity as a determinant of health has seldom been examined 56 (but see two recent studies examining pain among transgender individuals). 68,96 Between-group analysis risks obscuring the diversity that exists within most research samples, and meaningful information is lost that could help identify accurate targets for interventions.…”