Intersectional stigma among LGBTQIA+ adolescents with chronic primary musculoskeletal pain and its association with functioning and depressive symptoms.

Document Type

Article

Publication Date

1-2026

Identifier

DOI: 10.1037/hea0001509

Abstract

OBJECTIVE: Many adolescents with chronic primary musculoskeletal pain (CPMP) feel stigmatized by their pain condition. Studies have not previously evaluated whether having another stigmatized identity (i.e., intersectional stigma) contributes to poorer physical and psychosocial outcomes in this population. The current study evaluated the hypothesis that adolescents with CPMP identifying as having a minoritized sexual orientation and/or gender identity (lesbian, gay, bisexual, transgender, queer, intersex, and asexual [LGBTQIA+]) experience greater pain-related stigma, perceived injustice, functional impairment, and depressive symptoms relative to cisgender, heterosexual adolescents with CPMP.

METHOD: In total, 156 adolescents (12-17 years) with CPMP recruited from rheumatology and pain clinics at four children's hospitals across the United States completed self-report measures of pain-related stigma (Pain-Related Stigma Scale for Adolescents), depressive symptoms (Children's Depression Inventory 2nd Edition), perceived injustice (Injustice Experience Questionnaire), and functional disability (Functional Disability Inventory). Data were collected from August 2021 through March 2024. Adolescents reporting a marginalized gender identity (n = 34) and/or sexual orientation (n = 67) were included in the LGBTQIA+ group (n = 68). All others comprised the cisgender, heterosexual adolescents with CPMP only group (CPMPO; n = 88).

RESULTS: Our findings indicate higher pain-related stigma, functional disability, and depressive symptoms for the LGBTQIA+ group compared to the CPMPO group. The LGBTQIA+ group was more likely to report pain-related stigma from family members and school personnel compared to the CPMPO group. There were no significant differences in perceived injustice.

CONCLUSIONS: The findings of the current study highlight unique challenges for LGBTQIA+ adolescents with CPMP and justify future research in this area. Socioecological frameworks are warranted that consider pain-related and intersectional stigma in the evaluation and treatment of pediatric chronic pain conditions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Journal Title

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

Volume

45

Issue

1

First Page

38

Last Page

47

MeSH Keywords

Humans; Adolescent; Female; Male; Social Stigma; Child; Depression; Sexual and Gender Minorities; Musculoskeletal Pain; Chronic Pain; United States

PubMed ID

41396630

Keywords

Social Stigma; Depression; Sexual and Gender Minorities; Musculoskeletal Pain; Chronic Pain; United States

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