Background/Purpose: Recently, our center has noted a growing gender-diverse youth population with amplified musculoskeletal pain syndrome (AMPS)/Juvenile fibromyalgia (JF). Given the known disparities in access to care, pain prevalence, and psychosocial stressors among gender-diverse adolescents, we wanted to assess the baseline levels of pain and functioning and treatment outcomes with our AMPS/JF rehabilitation approaches in this population.

Methods: We performed a retrospective chart review of subjects with AMPS/JF in our multidisciplinary outpatient rehabilitation program, which involves 6-8 weeks of 12-15 appointments of PT and OT, home exercise program, and 6-8 psychology appointments (individual and family therapy). Five transgender subjects were identified and compared with five cisgender subjects matched by age, biological sex, race, and zip code. Demographic and clinical data were extracted, including age, biological sex, gender, social determinants of health, and pain scores. Functional outcomes were assessed using the Functional Disability Inventory (FDI) for patients and caregivers, administered both at admission and discharge.

Results: At baseline, cisgender and transgender/nonbinary subjects demonstrated comparable levels of functional impairment as measured by patient and caregiver FDI and baseline Pain Score. FDI range is 0-60, with higher scores indicating greater functional impairment. Patient FDI was 31 +/-5 for cisgender subjects and 32 +/-5 for transgender/nonbinary subjects, p=0.91. Caregiver FDI was 32 +/-7 for cisgender subjects and 26 +/-7 for transgender/nonbinary subjects, p=0.45. Interestingly, FDI variability was statistically greater in the transgender/nonbinary subjects (p=0.047). Baseline Pain Score was 4 +/-1 for cisgender subjects and 5.4 +/-1 for transgender/nonbinary subjects, p=0.35. No unique barriers to treatment participation or adherence were identified among the transgender cohort. Social determinants of health were not variably different between the two groups. Notably, every subject in both groups had a psychological diagnosis related to anxiety and/or depression.

Conclusion: In this preliminary dataset comparing cisgender and transgender adolescents with AMPS/JF, no significant differences were observed in functional or psychosocial outcomes upon entering our rehabilitation program, although there was greater range of dysfunction in transgender subjects. These findings overall suggest that transgender youth with AMPS/JF may respond similarly to existing treatment paradigms, despite the distinct psychosocial challenges experienced by this population. Post-intervention data collection is ongoing and may corroborate whether this population responds similarly to the current treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gender-diverse-youth-treatment-response-to-amplified-musculoskeletal-pain-syndrome-rehabilitation/