Chronic pain in transgender and gender diverse youth: A mixed-methods investigation

Transgender and gender diverse (TGD) youth have significantly worse mental health compared to cisgender youth because of the influence of gender minority stressors in society and consequent symptoms of gender dysphoria. Studies find that some TGD youth experience chronic pain, but research is lacking and the relationship is not well understood. The present study aims to better understand the relationship between gender and pain among TGD youth using mixed methods.

In total, 16 adolescents (Mage = 16.2 years; 37.5% transgender male) aged 13-18 with chronic pain and eight caregivers were recruited from pain, adolescent medicine, and gender clinics and completed self-report measures of pain burden, functional disability, gender minority stressors, and caregiver support. Subsequently, 12 adolescents and five caregivers completed focus groups discussing the relationship between gender and pain. Descriptive statistics were used for quantitative data and qualitative descriptive analysis for focus group data.

Adolescents reported moderate levels of pain burden and functional disability, high levels of gender minority stress, and high levels of caregiver support. Two core themes emerged from focus group discussions: the influence of (a) one's gender experience and (b) the overlap between gender and pain experiences.

The findings indicate a link between gender and pain experiences through factors related to gender minority stress, gender affirmation, social support, and gender dysphoria. The results provide support to existing research showing that TGD youth identify gender minority stressors as contributing to their challenges managing their health and pain. (PsycInfo Database Record (c) 2025 APA, all rights reserved).