MINI REVIEW article
Front. Pain Res.
Sec. Pediatric Pain
This article is part of the Research TopicUnpacking the Gender Pain Gap: Pain Prevalence, Perception, and Treatment Disparities by Gender, Including Transgender PopulationsView all 6 articles
Chronic Pain in Transgender and Gender-Diverse (TGD) Youth: A Biopsychosocial Perspective
Provisionally accepted
- 1Anesthesiology, Vanderbilt University Medical Center, Nashville, United States
- 2Department of Endocrinology, Boston Children's Hospital, Boston, United States
- 3Department of Psychiatry, Harvard Medical School, Boston, United States
- 4Department of Psychiatry and Behavioral Sciences; Department of Pediatrics; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States
- 5Pritzker Department of Psychiatry & Behavioral Health; Potocsnak Family Division of Adolescent & Young Adult Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, United States
- 6Department of Pediatrics; Anesthesiology; and Psychiatry and Biobehavioral Sciences, University of California Los Angeles David Geffen School of Medicine, Los Angeles, United States
- 7Founder and President, Creative Healing for Youth in Pain, Los Angeles, California, United States
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Chronic pain—including both chronic primary pain (e.g., headaches, widespread musculoskeletal pain, abdominal pain) and chronic secondary pain associated with other health conditions—represents a significant yet underrecognized health concern among transgender and gender-diverse (TGD) youth. While data on the prevalence of chronic pain in TGD youth remain limited, early studies indicate higher rates compared to their cisgender peers, highlighting the need for understanding factors underlying this co-occurrence. Chronic pain arises from a complex interplay of neurobiological, psychological, and social factors, and its heightened prevalence in TGD youth may be driven by the compounded impact of biopsychosocial stressors that disproportionately affect this group. This review summarizes neurobiological vulnerabilities, psychosocial factors, and societal and systemic barriers that may contribute to increased risk of chronic pain in TGD youth. We also examine the role of gender-affirming care in addressing these biopsychosocial vulnerabilities and explore its potential to alleviate some of the factors associated with chronic pain. Additionally, we identify critical gaps in the current body of research, such as the need for longitudinal studies and deeper exploration of the effects of medical interventions like pubertal suppression and exogenous hormones on chronic pain mechanisms and outcomes. By synthesizing the available evidence, we aim to guide future research and offer actionable recommendations to enhance clinical care and support for TGD youth experiencing chronic pain.
Keywords: biopsychosocial model, Chronic Pain, Gender diverse adolescents, gender identity, minority stress, transgender
Received: 19 Sep 2025; Accepted: 05 Dec 2025.
Copyright: © 2025 Han, Basch, Chen and Zeltzer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gloria T. Han
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