Challenges with embedding an integrated sex and gender perspective into pain research: Recommendations and opportunities

Edmund Keogh; Katelynn E Boerner

doi:10.1016/j.bbi.2023.12.027

Challenges with embedding an integrated sex and gender perspective into pain research: Recommendations and opportunities

Edmund Keogh, Katelynn E Boerner

University of British Columbia

Research output: Contribution to journal › Article › peer-review

12 Citations (SciVal)

Abstract

The focus of this article, within this BBI horizons special issue, is on sex, gender, and pain. We summarise what is currently known about sex- and gender-related variations in pain, exploring intersectional biological and psychosocial mechanisms, and highlight gaps in knowledge and understanding. Five key challenges with the exploration of sex and gender in pain research are presented, relating to: conceptual imprecision, research bias, limitations with binary descriptions, integrating sex and gender, and timely adoption/implementation of good research practice. Guidance on how to overcome such challenges is provided. Despite clear evidence for sex and gender differences in pain, there are conceptual and methodological barriers to overcome. Innovation in methods and approach can help develop more effective and tailored treatment approaches for men, women, boys, girls, and gender-diverse people.

Original language	English
Pages (from-to)	112-121
Number of pages	10
Journal	Brain Behavior and Immunity
Volume	117
Early online date	23 Dec 2023
DOIs	https://doi.org/10.1016/j.bbi.2023.12.027
Publication status	Published - 31 Mar 2024

Funding

There are existing guidance and policy recommendations to change research practice and distribute the responsibility. The International Association for the Study of Pain’s Special Interest Group on Sex, and Gender Differences in Pain published a consensus statement and guidance ( Greenspan et al., 2007 ). There is a need for this to be updated, to reflect current understanding. It is notable that this Special Interest Group has recently updated its name to include Racial Differences, highlighting the increasing importance of taking an intersectional approach in the study of sex/gender. More recently, general guidelines have been developed, which focus on sex as a biological variable, and gender as a sociocultural variable ( Heidari et al., 2016; Nielsen et al., 2021 ). Leadership is key to promoting implementation. For example, the US National Institutes of Health (NIH), the Canadian Institutes of Health Research (CIHR), and the European Commission (EC) introduced sex/gender policies into funding guidelines. However, guidance is not routinely taken up, and there is still a need to ensure data is disaggregated by sex and gender. This calls for the development of better measurement tools to study gender-related effects ( Gogovor et al., 2021; White et al., 2021 ). In pain, there is now an agreed approach across eight of the key pain journals (e.g., PAIN, The Journal of Pain, Pain Medicine) to improve the practice of ensuring diverse representation across scientific pain work ( Palermo et al., 2023 ). Edmund Keogh has received unrelated research grant funding from Versus Arthritis and UKRI (Medical Research Council, Biotechnology and Biological Sciences Research Council, Economic and Social Research Council), and provided consultancy services to RB plc via the University of Bath. Katelynn Boerner currently holds grant funding, unrelated to the present manuscript, from BC Children’s Hospital Research Institute, the Laurel Foundation, and the Canadian Institutes for Health Research.

Funders	Funder number
National Institutes of Health
UK Research and Innovation
Laurel Foundation
Canadian Institute of Health Research
Biotechnology and Biological Sciences Research Council
Economic and Social Research Council
European Commission
University of Bath
Versus Arthritis

Keywords

Biology
Gender
Pain
Psychosocial
Sex

ASJC Scopus subject areas

Endocrine and Autonomic Systems
Behavioral Neuroscience
Immunology

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10.1016/j.bbi.2023.12.027Licence: CC BY

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Challenges with embedding an integrated sex and gender perspective into pain research: Recommendations and opportunities

Abstract

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