Hormones, culture and puberty: How clinicians (don't) see gender in persistent pediatric pain

Abstract

Medical literature suggests that girls are affected by persistent pain disproportionately to boys especially following the onset of puberty. This article turns attention to how clinicians treating pediatric pain patients conceptualize the role of sex/gender in persistent pain and its care. Drawing on in-depth interviews with members of interdisciplinary pediatric pain care teams in Finland, we argue that sex/gender is an elusive object of alternating in/attention in pain care. We show that clinicians diverge in their views on the degree to which sex/gender matters in pediatric pain, and often express hesitance and ambivalence in their reflections on it. In the absence of clearly articulated conceptual tools for understanding sex/gender in pain, clinicians often fall back on either sociocultural clichés or reductionist biological explanations focusing on hormones. Such explanations present particularly girls' adolescence as a time of risk, a framing that is particularly prominent in accounts that foreground hormones. At the same time, critical voices within the field caution against stereotypical notions of ‘typical patients’ in pain care settings. By employing a social scientific perspective on persistent pain, the study extends existing interdisciplinary attempts to understand the complexities of sex/gender in pain and its care.