Gender Equity in Pain
Across Europe, women and girls are more likely to live with chronic pain, often with greater severity and functional impact, yet research, diagnosis and care have not kept pace. This position paper sets out why the gender pain gap is a matter of health equity, not a niche concern, and what EU and national policymakers can do about it.
Wider gender inequalities in power, employment, income and unpaid care are reflected in healthcare systems and in how medical evidence itself is produced.
The gender pain gap shapes who is believed, who receives a diagnosis, who accesses effective treatment, and who bears the wider cost of pain.
Pain experience varies across life, shaped by hormonal transitions, reproductive health and gendered social and occupational exposures.
Historical sex bias in research, under-representation of women in studies, and limited sex- and gender-disaggregated data hold back understanding and treatment.
A structural inequality made clinically visible
Across the EU, gender inequalities persist in areas such as power, rights, employment, income, unpaid care, and decision-making, creating cumulative disadvantages across the life course. These wider structural inequalities are also reflected in healthcare systems and in the production of medical evidence, where women’s bodies, symptoms, and outcomes have historically been under-represented, under-measured, or inadequately interpreted.
Pain is a clear example of how these inequalities become clinically visible. The gender pain gap refers not only to differences in pain prevalence, but also to how inequalities in research, healthcare, social roles, and working conditions influence who is believed, who receives a diagnosis, who accesses effective treatment, and who bears the wider social and economic consequences of pain.
Women and girls are more likely to experience many chronic pain conditions and often report greater pain severity and functional impairment. The paper also recognises that gender-diverse populations may experience both relevant biological factors and distinct barriers within healthcare systems. Pain experiences vary across the life course, influenced by hormonal transitions, reproductive health factors, and gendered social and occupational exposures.
Gaps in research and evidence generation
A key focus of the paper is the need to address gaps in pain research and evidence generation. Historical sex bias in preclinical and clinical research, insufficient representation of women in studies, limited sex- and gender-disaggregated data, and inadequate integration of these factors into guidelines have all contributed to gaps in understanding and treating pain. The paper calls for stronger investment in research, improved data collection, and gender-sensitive approaches across healthcare education and clinical practice.
Economic and societal consequences
The gender pain gap is not a niche issue, but a matter of health equity, disability, labour market participation, and long-term social sustainability. Chronic pain creates substantial burdens for individuals, healthcare systems, employers, and societies. As women are more likely to experience chronic pain and also carry a disproportionate share of unpaid care responsibilities, pain can contribute to interrupted careers, reduced working hours, income insecurity, and cumulative disadvantage across the life course.
Addressing the gender pain gap therefore requires coordinated action across research, healthcare, education, employment, and policy. Integrating sex- and gender-sensitive approaches into pain prevention, assessment, management, and monitoring is both feasible and necessary to improve quality of care, advance health equity, and support EU commitments to gender equality and inclusive growth.
SIP Position Paper on Gender Equity in Pain
Full evidence base, references, and recommendations in one document.
Six recommendations for policymakers
The SIP Platform calls on EU and national policymakers to take coordinated action across research, healthcare, education, employment, and policy.
Make sex and gender visible in pain data and indicators
Ensure pain surveillance systems, registries and research programmes systematically collect, analyse and report sex- and gender-disaggregated data, integrated into pain indicators and monitoring frameworks.
Fund and prioritise research on gendered pain mechanisms and conditions
Increase targeted funding for research on sex- and gender-specific pain mechanisms and female-predominant conditions, and require balanced representation and sex-specific analyses across studies.
Integrate gender-sensitive pain assessment and management into education and practice
Embed gender-sensitive pain assessment, management and bias awareness into healthcare education, clinical guidelines and professional training to improve diagnostic accuracy and equitable treatment.
Tackle the gender pain gap in access to diagnosis, treatment and support
Strengthen referral pathways, specialist access and service organisation to reduce delays in diagnosis and treatment for pain conditions that disproportionately affect women.
Strengthen participation and leadership of women in pain research and policy
Promote the retention, advancement, and leadership of women in pain research, clinical leadership, and policymaking, while supporting excellence among all researchers.
Address the social and employment impacts of gendered pain
Integrate chronic pain into employment, social protection and equality policies to mitigate its disproportionate impact on women’s work participation, income security and unpaid care burden.