Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 27:5:1241015.
doi: 10.3389/fpain.2024.1241015. eCollection 2024.

Pain mechanisms in the transgender individual: a review

Jennifer T Anger  1 , Laura K Case  2 , Andrew P Baranowski  3 , Ardin Berger  4 , Rebecca M Craft  5 , Lyn Ann Damitz  6 , Rodney Gabriel  7 , Tracy Harrison  8 , Kirsten Kaptein  9 , Sanghee Lee  1 , Anne Z Murphy  10 , Engy Said  7 , Stacey Abigail Smith  11 , David A Thomas  12 , Maria Del C Valdés Hernández  13 , Victor Trasvina  1 , Ursula Wesselmann  14 , Tony L Yaksh  2
Affiliations
Review

Pain mechanisms in the transgender individual: a review

Jennifer T Anger et al. Front Pain Res (Lausanne). .

Abstract

Specific aim: Provide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research.

Methods: A team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research.

Results: While transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain.

Conclusions: While significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.

Keywords: gender affirming care; gender binary system; hormone replacement therapy (HRT); post operative pain; transgender (GLBT) issues.

PubMed Disclaimer

Conflict of interest statement

ETS and UCSD has received funding and/or product for research from Epimed International (Dallas, TX) SPR Therapeutics (Cleveland, OH), Infutronix (Natick, MA), and Avanos (Irvine, CA). LC. Associate Editor for Frontiers in Pain Research. LC did not participate in the journal review process leading to the acceptance of this manuscript. MV. Chief Specialty Editor in Frontiers in Medical Technology. UW serves on the External Consultant Board for the “NIH Preclinical Screening Platform for Pain” (NIH/NINDS). In her capacity as a special government employee of the US Food and Drug Administration (FDA), she has served as a voting member of the FDA Anesthetic and Analgesic Drug Products Advisory Committee. In the past 3 years she has received compensation for serving on advisory boards or for consulting activities for Aphrodite Health Inc., Wilmington, DE, Avenue Therapeutics Inc., New York, NY, Bayer Aktiengesellschaft, Leverkusen, Germany, Biohaven Pharmaceuticals, New Haven, CT, and Syneos Health, Morrisville, NC, all unrelated to the submitted work. Reports research grants from the US National Institutes of Health. TY reports being a founder of Raft Pharmaceutical, SAB Navega Pharma all unrelated to the submitted work and is the Editor in Chief for Frontiers in Pain Research. TY did not participate in the journal review process leading to the acceptance of this manuscript. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Matsuno E, Budge SL. Non-binary/genderqueer identities: a critical review of the literature. Curr Sex Health Rep. (2017) 9:116–20. 10.1007/s11930-017-0111-8 - DOI
    1. Kronk CA, Everhart AR, Ashley F, Thompson HM, Schall TE, Goetz TG, et al. Transgender data collection in the electronic health record: current concepts and issues. J Am Med Inform Assoc. (2022) 29(2):271–84. 10.1093/jamia/ocab136 - DOI - PMC - PubMed
    1. Miyagi M, Guthman EM, Sun SED. Transgender rights rely on inclusive language. Science. (2021) 374(6575):1568–9. 10.1126/science.abn3759 - DOI - PubMed
    1. Price-Feeney M, Green AE, Dorison SH. Suicidality among youth who are questioning, unsure of, or exploring their sexual identity. J Sex Res. (2021) 58(5):581–8. 10.1080/00224499.2020.1832184 - DOI - PubMed
    1. Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. (2013) 111(1):52–8. 10.1093/bja/aet127 - DOI - PMC - PubMed