Abstract
ObjectivePain without known pathology, termed “functional pain,” causes much school absenteeism, medication usage, and medical visits. Yet which adolescents are at risk is not well understood. Functional pain has been linked to childhood abuse, and sexual orientation minority youth (gay, lesbian, bisexual, “mostly heterosexual,” and heterosexual with same-sex sexual contact) are more likely to be victims of childhood abuse than heterosexuals, thus may be at greater risk of functional pain.MethodsWe examined sexual orientation differences in past-year prevalence of functional headache, pelvic, and abdominal pain and multiple sites of pain in 9,864 young adults (mean age = 23 years) from a large U.S. cohort. We examined whether childhood abuse accounted for possible increased risk of functional pain in sexual minority youth.ResultsSexual minority youth, except for gays and lesbians, were at higher risk of functional pelvic and abdominal pain and multiple sites of pain than heterosexuals. Gay and lesbian youth had elevated prevalence only of abdominal pain. Childhood abuse accounted for 14% to 33% of increased experience of multiple sites of pain in minority youth.ConclusionsYouth who identify as “mostly heterosexual” or bisexual or who identify as heterosexual and have had same-sex partners comprised 18% of our sample. Clinicians should be aware that patients with these orientations are at elevated risk of functional pain and may be in need of treatment for sequelae of childhood abuse. Conventional categorization of sexual orientation as heterosexual or homosexual may fail to distinguish a large number of youth who do not wholly identify with either group and may be at elevated risk of health problems.
Highlights
Pain without known pathology is termed ‘‘functional pain’’ and can include recurrent abdominal pain, headache, backache, pelvic and musculoskeletal pain
In this paper we examine whether sexual minority young adults report more functional pain, including headache, abdominal pain, and pelvic pain, than heterosexuals in a large U.S cohort, the Growing Up Today Study (GUTS)
To ascertain whether sexual orientation was associated with presence of functional pain adjusted for covariates, we modeled each type of pain and pain in two or more sites as the dependent variable with sexual orientation as the independent variable
Summary
Pain without known pathology is termed ‘‘functional pain’’ and can include recurrent abdominal pain, headache, backache, pelvic and musculoskeletal pain. Functional pain causes much impairment, disability, and medical care usage. Functional pain is associated with school absenteeism [1], medication usage, and medical visits [2]. Patients with multiple medically unexplained pains and symptoms incur more than twice the medical expenses of patients without such symptoms. Extrapolated to the whole U.S, these elevated expenses amount to $256 billion excess medical costs annually attributable to functional pain and symptoms [3]. Identifying groups at increased risk for functional pain and gaining better understanding about possible causes of functional pain in those groups is of great public health interest
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