The Influence of Sex and Gender, Gender Ontological Beliefs, and Sexism on Pain Sensitivity Judgments: Implications for Health Care Settings and Beyond

Chronic pain affects at least one in five individuals. Hence, adequate pain judgement is a vital interpersonal skill. Nonetheless, women often face treatment disparities due to biased assessments. Priorly, sex and gender (i.e., biological category vs. cultural representation) have not been investigated separately. Our study was thus designed to disentangle their distinct influence on pain judgments. In an online study, N = 679 participants (73.8% female) were presented with a novel vignettes paradigm including descriptions of fictional gender-stereotypical and counter-stereotypical women and men. Participants were instructed to rate the characters' pain sensitivity before completing inventories measuring gender ontological beliefs and ambivalent sexism. We found significant interaction effects of observer and character sex, in that higher pain sensitivity was attributed to opposite-sex characters. Men showed a higher sex bias, which was partially mediated by lower social constructionism and higher hostile sexism. We further uncovered a gender bias across observers, in that feminine characters were assumed to be more pain sensitive, irrespective of their sex. Our research underscores the presence of sex and gender biases in pain judgments, even in scenarios with minimal contextual cues. Despite limitations, the findings offer insights for the development of intervention strategies, which might reduce treatment disparities.