Carrying a double burden: The impact of pain and gender-related stigma in women with chronic pelvic pain

Jenna M Wilson; Savannah Kazemipour; Diya Dharmendran; Samantha M McKetchnie; Michaela Sawada; Emily J Bartley; Samantha M Meints

doi:10.1016/j.jpain.2026.106251

Carrying a double burden: The impact of pain and gender-related stigma in women with chronic pelvic pain

J Pain. 2026 Feb 26:42:106251. doi: 10.1016/j.jpain.2026.106251. Online ahead of print.

Authors

Jenna M Wilson¹, Savannah Kazemipour², Diya Dharmendran³, Samantha M McKetchnie⁴, Michaela Sawada⁴, Emily J Bartley⁵, Samantha M Meints⁴

Affiliations

¹ Department of Anesthesia, Mass General Brigham, Harvard Medical School, Boston, MA, USA. Electronic address: jwilson47@mgb.org.
² Department of Anesthesia, Mass General Brigham, Harvard Medical School, Boston, MA, USA; Lake Erie College of Medicine, Erie, PA, USA.
³ Texas A&M, College Station, TX, USA.
⁴ Department of Anesthesia, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
⁵ University of Florida, College of Dentistry, Gainesville, FL, USA.

PMID: 41763345
DOI: 10.1016/j.jpain.2026.106251

Abstract

Women with chronic pelvic pain (CPP) often experience stigma related to both their gender identity and chronic pain status, as symptoms are frequently dismissed, disbelieved, or attributed to psychological causes, negatively affecting care. This study examined how chronic pain and gender-related stigma intersect in cisgender women with CPP and their associations with pain and psychosocial factors. Participants completed an online survey with validated questionnaires assessing stigma, pain severity and interference, physical functioning, and psychosocial factors. Pain stigma was correlated with greater pain severity and interference, poorer physical functioning, higher depression and perceived injustice, and lower pain self-efficacy, self-esteem, and social support, even after controlling for gender-related stigma. In contrast, gender-related stigma was correlated with lower social support, but also with lower pain and better physical functioning when controlling for pain stigma. A composite variable representing intersectional stigma categorized participants into four groups: high pain/high gender stigma, low pain/high gender stigma, high pain/low gender stigma, and low pain/low gender stigma. Analyses of covariance examined intersectional group differences in pain and psychosocial factors. Women high in both pain and gender-related stigma reported the most adverse profile across pain and psychological factors, highlighting the compounded challenges of confronting both forms of stigma. Women high in gender-related stigma, regardless of pain stigma, reported the lowest social support, suggesting that gender-related stigma may be especially linked to social factors. These findings underscore the need for stigma-reduction initiatives for chronic pain, with attention to the unique challenges faced by women experiencing both pain and gender-related stigma. PERSPECTIVE: Using an intersectional framework, this study examined associations of pain- and gender-related stigma with pain and psychosocial factors in cisgender women with chronic pelvic pain. Women reporting high levels of both stigmas exhibited the most adverse pain and psychological profiles, highlighting the compounded challenges of confronting multiple, intersecting stigmas.

Keywords: Chronic pain stigma; Chronic pelvic pain; Gender stigma.