The gender context of pain

Abstract

Pain is a major source of global suffering, with women bearing the greatest burden.Alongside biology, psychological and social factors, including gender, help explain these differences. However, there has been no direct attempt to develop a unified social psychological model of men and women's pain. By drawing on approaches to both gender and pain, a gender context model of pain is presented. It proposes that pain is partly influenced by the gender context in which it occurs, which operates at both individual and interpersonal levels. The model is used to structure an appraisal of the existing evidence around gender and pain, and explore whether the model helps explain why such variation occurs. It is argued that despite evidence for an association between gender and pain, there are empirical gaps that need to be addressed. Implications and directions for future investigations into sex, gender and pain are considered.

The Influence of Examiner Gender on Responses to Tonic Heat Pain Assessments: A Preliminary Investigation

“…To our knowledge, the effect of examiner gender on pain outcomes has been explicitly tested in six previous studies (see Table 3 for description) ( 9 , 10 , 17 – 19 , 22 ). For subjective pain ratings, our observations correspond with those reporting an opposing examiner gender effect ( 9 , 10 , 17 , 18 ) as well as social theories of pain which propose the gender context in which pain is expressed influences pain report ( 12 ). The former was evidenced in our reported verbal ratings in women, which were significantly higher in the presence of a female compared to a male examiner.…”

“…Taken together, our findings provide evidence for a dissociation between pain experience and pain reporting, which is influenced by examiner gender. Overall, this lends support to the Gender Context Model of Pain ( 12 ), in that outcomes with the most social communication were more influenced by experimenter gender.…”

“…To that end, PCT was more resilient to gender effects compared to verbal or CoVAS outcomes, as examiner gender did not significantly influence PCT. These findings provides further support for the social context of pain model, as PCT is less clearly a “rating” of pain to an examiner, and thus less influenced by the social context ( 12 ).…”

“…However, this difference may be dependent on how pain is expressed. Verbal pain report may be more susceptible to these gender differences than non-verbal expressions ( 11 , 12 ). Indeed, individual factors add complexity.…”

Editorial: Differences in Pain Biology, Perception, and Coping Strategies: Towards Sex and Gender Specific Treatments

“…Sex and gender differences in pain have been a point of focus in the medical field and continue to gather increasing interest (Dance, 2019;Mogil, 2020;Templeton, 2020). In this line, biological, psychological, and social influences on pain have been investigated (Fillingim, 2015;Keogh, 2020). Building upon the accumulating knowledge of mechanisms underlying sex and gender differences in pain (Bartley and Fillingim, 2013;Chen et al, 2018;Kim and Kim, 2020) has led to an escalating interest in gender and sex-specific treatments in medicine and pain (Packiasabapathy and Sadhasivam, 2018;Mauvais-Jarvis et al, 2020;Templeton, 2020).…”