top of page

Child Psychiatrist /Adult Psychiatrist

High Scores for Adverse Childhood Experiences Linked to Chronic Pain in LGBTQ+ Adults

Keypoint: Adults who identify as LGBTQ+ report more ACEs and are more likely to report chronic pain than adults who do not identify as LGBTQ+.


In adults who identify as lesbian, gay, bisexual, transgender, queer, etc. (LGBTQ+), high scores for adverse childhood experiences (ACEs) were associated with higher average pain scores in the last 6 months and higher ratings of perceived pain, according to study results published in Anesthesia and Analgesia.


Chronic Pain

Childhood adversity is associated with chronic pain in adults. Adults who identify as LGBTQ+ report more ACEs and are more likely to report chronic pain than adults who do not identify as LGBTQ+. However, little is known about the link between chronic pain and childhood adversity in the LGTBQ+ community, despite their disproportionate burden of chronic disease.


To address chronic pain effectively in those who identify as LGBTQ+, researchers sought to understand the link between childhood adversity and chronic pain, especially in the transgender and gender-diverse individuals. The researchers at the University of California conducted a cross-sectional study of adults aged 18 years or older, who identified as LGBTQ+, and reported chronic pain.


To conduct the study, surveys were electronically distributed from August 2022 to November 2022 through the email listservs and social media platforms of LGBTQ+ organizations. Demographic information was collected from the surveys and the validated Chronic Pain Questionnaire as well as a validated instrument that measured childhood adversity via the ACE score was incorporated. The researchers considered ACE scores of 4 or more to be high.


The researchers analyzed responses from 136 participants. The study group’s mean age was 29 ± 7.4 years, and the group’s mean pain rating in the last 6 months was 5.9 of 10. For 80% of participants, their worst pain was rated at least 7 of 10. Around half the group (47%), had high ACE scores, which were associated with greater 6-month average pain scores and higher ratings of perceived current pain.


The mean 6-month pain score for the group was 6.27±1.79, and the mean difference was -2.22 (95% CI, -1.2 to 0.0; P =.028). Their rating of perceived current pain was 4.53±2.16, and the mean difference was -2.78 (95% CI, -1.9 to -0.3; P =.007).


The study also found that the 75 transgender and gender diverse participants in the study had higher ACE scores than those who were cisgender. More specifically, the median absolute difference between gender identity groups in this measure was 1 (95% CI, 0.0-2.0; P =.004). In addition, the current pain scores of transgender and gender diverse adults were 3.9±1.8 compared with 3.0±1.9 for cisgender adults (95% CI, 0.0-0.3; P =.009).


The researchers reported nearly 38% of study participants had a history of sexual trauma, which was associated with chronic pelvic pain (effect size estimate, 0.21; P =.016). Having a history of forced sexual touch or touch encounters was associated with having received a diagnosis of fibromyalgia. Additionally, for having a history of forced sexual touch, the effect size estimate for fibromyalgia was 0.31 (P =.008), and for having a history of touch encounters, the effect size estimate for fibromyalgia was 0.31 (P =.037).


Study limitations include the study’s cross-sectional design, the limited diversity of the study participants and the lack of computer savvy participants. Study results cannot be generalized to other racial groups or to those who were not computer savvy.


“Childhood adversity and chronic pain’s dose-dependent relationship among our LGBTQ+ sample indicates a need to explore trauma’s role in perceived pain,” the researchers concluded. “Given sexual trauma’s association with pain location and diagnosis, type of trauma may also be crucial in understanding chronic pain development,” they added, “[B]y understanding the link between childhood adversity and chronic pain, health care providers can ensure to especially screen vulnerable populations, such as LGBTQ+ patients, for ACEs.”


Note: This article originally appeared on Clinical Pain Advisor

0 views0 comments

Comentários


bottom of page