Perceptions of gendered and ungendered pain relief norms and stereotypes using Q-methodology

Abstract

Pain is ubiquitous, but effective pain relief eludes many. Research has shown that some pain behaviours are perceived as gendered, and this may influence the way men and women express and cope with pain, but such enquiries have not extended to specific methods of pain relief. Our aim was to explore perceptions of the most socially acceptable ways for men and women to relieve pain. Across two studies, sixty participants (50% male) aged 18-78 completed a Q-sort task, sorting different pain relief strategies by the social acceptability for either women (Study 1; N=30) or men (Study 2; N=30). Analyses revealed two stereotypes for each sex. The overarching stereotype for women suggested it is most acceptable for them to use pain relief strategies considered conventional and effective. However, a second stereotype suggested it is most acceptable for women to use strategies which generally conform to feminine gender norms and stereotypes. The overarching male stereotype suggested it is most acceptable for men to use pain relief aligned with stereotypical masculinity, however a second stereotype also emerged, characterised by conventional and effective responses to pain, much like the overarching stereotype for women. These differing viewpoints seem to depend on whether gender norm conformity or perceived analgesic efficacy is thought to determine social acceptability. These studies provide initial evidence of both a gendered and ungendered lens through which pain relief can be viewed, which may influence how men and women use pain relief.

Exploring the relationship between male norm beliefs, pain‐related beliefs and behaviours: An online questionnaire study

“…A similar effect was not found for crying, however, although we did find women viewed holding the body as more indicative of a how women express pain. These findings are consistent with work into gender‐based expectations around pain coping (Keogh & Denford, ; Wratten et al, ). They also relate to evidence that gender‐based expectations affect how health care providers judge the pain of others (Bernardes, Costa, & Carvalho, ; Hirsh, Hollingshead, Matthias, Bair, & Kroenke, ; Samulowitz, Gremyr, Eriksson, & Hensing, ; Schafer, Prkachin, Kaseweter, & Williams, ).…”

“…Experimental studies confirm that identification with masculine traits are associated with higher pain thresholds, whereas identification with feminine traits are related to greater pain sensitivity (Alabas, Tashani, Tabasam, & Johnson, ). Gender also affects how pain is expressed and responded to (Bernardes & Lima, ; Bernardes, Silva, Carvalho, Costa, & Pereira, ; Robinson et al, ; Wratten, Eccleston, & Keogh, ).…”

The gender context of pain

“…If sex and gender affect the way observers respond to those in pain, the question is whether this is due to gender-based beliefs and expectations. Empirical studies confirm the existence of stereotypical gender beliefs about pain (Bernardes, Silva, Carvalho, Costa, & Pereira, 2014;Keogh & Boerner, 2020;Keogh & Denford, 2009;Robinson, Gagnon, Dannecker, et al, 2003;Wesolowicz, Clark, Boissoneault, & Robinson, 2018;Wratten, Eccleston, & Keogh, 2019). For example, found that women are viewed as more sensitive to pain, and men less willing to report pain to others.…”

“…Keogh and Denford (2009) found expectations that women catastrophise more than men, and that men use distraction more than women. Wratten et al (2019) found that some pain coping strategies are considered more masculine (e.g., swearing, alcohol use), whereas other strategies are viewed as more feminine (e.g., crying, social support). Some studies also find that such stereotypical gender-based beliefs affect how individuals judge the pain of others (Hobara, 2005;Robinson & Wise, 2003;Schafer et al, 2016).…”

Sex and gender differences in pain: past, present, and future

“…2,45,63 Stereotypical gender beliefs and expectations about pain are also relevant. 21,96,99,197 For example, men are considered less expressive and more likely to engage in avoidance when in pain, whereas women are perceived to be more likely to catastrophize and cry. Importantly, these beliefs have been shown to impact on how pain is expressed and responded to, [156][157][158] including with pain medication use.…”