Invisible pain: Sex/gender differences in pain-related stigma

Acta Psychol (Amst). 2026 Apr 16;266:106838. doi: 10.1016/j.actpsy.2026.106838. Online ahead of print.

ABSTRACT

OBJECTIVE: Stigma is associated with worse pain, function, and negative affect (i.e., health outcomes). It is unclear whether the well-documented sex/gender disparities in health outcomes extend to stigma and whether relationships between stigma and health outcomes differ by sex/gender. This study examined (1) sex/gender differences in pain, mental health, and opioid stigma (i.e., health-related stigma); (2) the relationships between health-related stigma and health outcomes; and (3) whether sex/gender moderates relationships between health-related stigma and health outcomes.

DESIGN: This is a secondary analysis of cross-sectional baseline data from an RCT of multimodal treatment for adults with CLBP and negative affect.

SETTING: Three academic medical centers across the Midwest and Northeast.

METHODS: 261 adults completed measures of pain, mental health, and opioid medication stigma, pain, function, and negative affect upon enrollment. We compared health-related stigma and health outcomes across cisgender men and women, examined correlations between stigma and health outcomes, and explored sex/gender as a potential moderator of the relationship between stigma and health outcomes.

RESULTS: Chronic pain stigma was associated with greater pain, poorer function, and greater (i.e., worse) negative affect, whereas mental health and opioid stigma were primarily associated with greater negative affect. There were no sex/gender differences in stigma or health outcomes nor did sex/gender moderate the relationships between stigma and outcomes.

CONCLUSIONS: Stigma interventions may improving health outcomes among adults with CLBP and may be similarly important for men and women.

PMID:41997076 | DOI:10.1016/j.actpsy.2026.106838