Sex related differences, without taking gender into account, in chronic pain have been widely researched over the past few decades in predominantly cisgender and heterosexual populations. Historically, chronic pain conditions have a higher incidence and prevalence in cisgender women, including but not limited to fibromyalgia, irritable bowel syndrome, and migraine. The goal of the present study was to identify and characterize the presence and characteristics of chronic pain in SM and GM persons using data from The PRIDE Study, which is the first large-scale, long-term national cohort health study of people who identify as lesbian, gay, bisexual, transgender, queer, or as another sexual or gender minority person. A total of 6189 adult participants completed The PRIDE Study 2022 Annual Questionnaire at the time of data analysis. A total of 2462 participants reported no chronic pain, leaving 2935 participants who reported experiencing chronic pain. The findings from this study highlight that chronic pain is present to a significant degree in sexual and gender minority adults who participated in The PRIDE Study with chronic spine pain being the most common location/region of pain. Notably, more than one-third of non-binary persons, transgender men, and people who selected another gender experienced chronic widespread pain, defined by having 3 or more total regions of chronic pain. The lowest prevalence of chronic widespread pain was among transgender women and cisgender men. When considering sexual orientation, the highest prevalence of widespread pain was in participants who selected another sexual orientation, followed by queer and asexual, demisexual ,gray ace, with the lowest prevalence of chronic widespread pain being in those who identify as straight or heterosexual, bisexual, pansexual, gay, and lesbian. Future studies are planned to elucidate how a variety of biopsychosocial mechanisms may influence chronic pain in sexual and gender minority persons.

MRL has received consulting fees from Hims, Inc.; Folx Health, Inc.; and Otsuka Pharmaceutical Development and Commercialization, Inc. for work unrelated to this work. JOM has received consulting fees from Hims, Inc.; Folx Health, Inc.; and Sage Therapeutics for work unrelated to the study described here. ALC has received consulting fees from Swing Therapeutics and Scilex Pharmaceuticals for work unrelated to the study described here.

Dr. Chadwick is supported in part by the National Institute of General Medical Science (K23GM123320) and the National Institute of Neurological Disorders and Stroke (RM1NS128956). Dr. Flentje is supported in part by the National Institute on Drug Abuse (K24DA057874). This study was also partially supported by the National Institute of Diabetes and Digestive and Kidney Diseases (K12DK111028) to JOM. Research reported here was partially supported by funding from the Patient-Centered Outcomes Research Institute (PPRN 1501 26848) to MRL. The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of Patient Centered Outcomes Research Institute or the National Institutes of Health.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Consent was obtained electronically and institutional review board approval was obtained from the University of California, San Francisco, Stanford University, and WIRB-Copernicus Group (WCG) IRB.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study may be available upon reasonable request to the PRIDE Study leadership team.