Pain in the Transgender Individual

Sex and gender are constructs that reflect wide variations in underlying biology and physiology, in addition to sociocultural factors. An under-studied group in this constellation is the transgender individual. Many researchers and clinicians are not aware of the medical and surgical treatments and non-medical practices (like tucking and binding) that some transgender individuals choose to undergo. Researchers and clinicians may work in a field that intersects with medical issues related to treatment in transgender individuals (hormonal therapy, pain management, oncology – breast cancer), yet many of them are not familiar with how transgender individuals experience their bodies before, during, and after gender-affirming medical and surgical treatments. The intersection of gender and pain is an important area of research, but only recently has pain in the transgender population begun to be addressed. Pain in the transgender individual encompasses multiple clinical domains, including pain due to chest binding/tucking, differences in pain before and after hormonal therapy, differences in pain pre and post-surgery, social pain or amplification of chronic pain due to stigma/discrimination/treatment barriers, and intersections of pain with gender and body dysphoria. The journal has established a working group to consider these issues raised by pain in these individuals. The journal is sponsoring a major scoping article to be published on this topic by this working group.

The journal now invites research and in depth review articles on allied subjects, including, but not limited to:

· Pain profiles across the life span of transgender individuals;
· Role of social processes related to discrimination and marginalization (transphobia, socioeconomic disparities, structural racism) in pain and opioid use
· Impact of gender dysphoria and body image on pain and opioid use in transgender and gender nonbinary individuals
· Effects of gonadal hormones/replacement agents on pain thresholds in cis-gender and transgender individuals;
· Animal models that reflect effects of gender affirmation interventions on pain phenotype and pharmacology;
· Differences in pain perception linked to gender-related differences in brain structure or connectivity;
· Effects of gender-affirming surgery on genital sensory innervation and pain processing;
· Analgesic pharmacology in the transgender and nonbinary population as compared to cis populations;
· Implications for anesthesia, acute and chronic pain treatment and cancer pain management in transgender individuals

Keywords: Transgender Individuals, Pain, Discrimination, Marginalization, Gender Dysphoria, Gender-Affirming Surgery

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.