Gender Equity in Pain

The SIP Position Paper on Gender Equity in Pain (2026) sets out the joint position of the European Pain Federation EFIC and Pain Alliance Europe (PAE) on the interconnected challenges of gender equity and pain. It highlights persistent sex- and gender-related inequities in pain research, recognition, diagnosis, treatment, and access to care, and presents key recommendations for EU and national policymakers to promote systemic change.

The paper highlights that 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 the production of medical evidence, where women’s bodies, symptoms, and outcomes have historically been underrepresented, 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.

The paper further highlights that women and girls are more likely to experience many chronic pain conditions and often report greater pain severity and functional impairment. It also recognises that gender-diverse populations may experience both relevant biological factors and distinct barriers within healthcare systems. Importantly, pain experiences vary across the life course, influenced by hormonal transitions, reproductive health factors, and gendered social and occupational exposures.

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 contributed to gaps in understanding and treating pain. The paper therefore calls for stronger investment in research, improved data collection, and gender-sensitive approaches across healthcare education and clinical practice.

From an economic and societal perspective, the paper argues that 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.

The paper therefore concludes that addressing the gender pain gap 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.