Pain processing represents a highly complex field with significant variations arising from both biological (sex) and psychosocial (gender) factors, influencing neural circuits and neurotransmitters. Despite the evidence that sex- and gender-specific differences exist, research often simplifies these variables into binary categories.

Recent studies highlight that chronic pain syndromes, such as migraine, fibromyalgia, and trigeminal neuralgia, predominantly affect females, while others, like cluster headaches, are more prevalent in males. However, gaps remain in understanding how gender identity beyond binary definitions—such as transgender, cisgender, genderqueer, non-binary or gender-fluid identities—relates to the clinical manifestation, prevalence, and therapeutic responses of chronic pain conditions.

This Research Topic aims to characterize and elucidate sex-related biological and gender-related psychosocial phenotypes in neuropathic and nociplastic chronic pain conditions, specifically migraine, fibromyalgia, and other related syndromes. We seek to explore how specific gender expressions influence clinical presentation, comorbid psychiatric or psychological conditions, social and occupational realities, and treatment efficacies. Another critical goal is clearly distinguishing and operationalizing the concepts of "sex" and "gender" in clinical and research contexts, contributing to more tailored and effective therapeutic strategies.

To gather further insights in the identification of gender-specific and sex-specific clinical phenotypes, the Research Topic will consider neuropathic pain and nociplastic pain conditions, while emphasizing clarification and appropriate use of gender and sex terminology. We welcome articles addressing, but not limited to, the following themes:
o Clinical phenotype variations in neuropathic and nociplastic pain influenced by gender identity and gender expression.
o Differential comorbidities (psychiatric disorders, mood disorders, social isolation) correlated with gendered experiences of chronic pain.
o Impact of gender identity on pain perception, reporting, and management strategies.
o Sex-specific responses and variability in pharmacologic and non-pharmacologic treatments, including placebo effects.
o Socioeconomic and occupational burden of chronic pain syndromes across gender spectra.
o Methodological approaches to better differentiate and operationalize sex versus gender in chronic pain research.
o Mechanistic and biological underpinnings of hormonal and neurochemical differences in gender-related pain conditions.

We look forward to original research and reviews contributing comprehensive analyses and evidence-based discussions of these themes.

Article types: Original Research, Review, Systematic Reviews, Meta-Analysis.

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Exploring gender-related phenotypic differences in neuropathic and nociplastic pain

Topic Coordinator