Background/Purpose: Pediatric chronic pain is a common, significant public health concern leading to decreased quality of life for youth and burden on the healthcare system¹. While there is research highlighting the benefit of a biopsychosocial model to treat chronic pain, there are disparities in access to evidence-based care². Anecdotally, youth who identify with transgender or non-binary gender identities may not be referred to interdisciplinary pediatric chronic pain programs as often as cis-gender youth. The current study aimed to explore baseline characteristics of youth referred to an outpatient interdisciplinary pediatric chronic pain program at an East Coast children’s hospital across gender identity.

Methods: Youth completed questionnaires electronically as part of the initial evaluation within an outpatient interdisciplinary pediatric chronic pain program. From February 2020-April 2023, 335 youth completed questionnaires including the Chronic Pain Acceptance Questionnaire, PROMIS Pain Interference, and PROMIS Anxiety. Of these, 248 identified as cisgender female, 48 identified as cisgender male, 25 identified as non-binary, and 4 identified as transgender.

Results: Overall, 8.7% of the sample identified as gender diverse, which is a higher percentage as compared to national rates in the US for young adults (5.1%)⁶. Average age of the sample was 14 years old. Youth were predominately Non-Hispanic (92.7%) and White (83%). Youth who identified as transgender reported the highest pain acceptance scores. Cisgender males reported the least anxiety. Youth with non-binary gender identity reported the lowest pain acceptance, highest pain interference, and highest levels of anxiety. There were no statically significant differences in pain inference between cisgender and nonbinary youth.

Conclusion: These data represent a first look at exploring characteristics of youth and gender identity for patients entering a pediatric chronic pain program. Interestingly, youth with nonbinary gender identity did not differ in functional impairment, but appeared to experience higher levels of self-reported anxiety and lower acceptance of pain. This suggests these youth may have a decreased willingness to engage in activities in the face of pain or experience pain generally. Awareness of a patient’s gender identity may be beneficial in understanding the impact of pain and highlights the need for a biopsychosocial model approach to pain management. This study was limited by relatively small numbers and does include youth already referred to a pain program. More research is needed to explore the role of gender identity as it relates to pain management, and referral patterns.

References
1. King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 152(12), 2729-2738.

2. Jay, M. A., & Howard, R. F. (2016). Inequalities in access to a tertiary children’s chronic pain service: a cross-sectional study. Archives of Disease in Childhood, 101(7), 657–661. doi: 10.1136/archdischild-2015-310280

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exploring-psychosocial-characteristics-of-youth-with-chronic-pain-across-gender-identities/