Transgender Research Articles

Cancer Screening and Prevention in the Transgender and Gender Diverse Population: Considerations and Strategies for Advanced Practice Nurses

ObjectivesThis discussion paper presents recent evidence regarding cancer screening and prevention among the transgender and gender diverse (TGD) community and highlights where and how advanced practice nurses (APNs), particularly those in primary care, can better contribute to closing the gap between healthcare disparities between TGD and cisgendered populations. MethodsRelevant publications on the topic and professional guidelines and evidence have formed the basis for this discussion paper. ResultsTGD individuals are a vulnerable population with unique needs. They remain at risk of cancer and might be at greater risk of developing some cancers compared to cisgendered people but are underscreened. Barriers to gender-affirming care need to be addressed to improve access to prevention and screening services and improve the cancer care experiences and outcomes of TGD people. ConclusionAPNs can work in collaboration with TGD individuals and the healthcare system to improve access to culturally safe cancer screening and more effective prevention of cancer and poor cancer outcomes. Implications for Nursing PracticeAPNs have the potential to improve access to cancer screening for TGD people by increasing their understanding of the needs of the population, providing culturally safe care, and advocating for more preventative care and cancer screening. With greater knowledge and understanding of the needs and preferences of TGD people both broadly and in relation to cancer screening and prevention, targeted interventions and care approaches can be implemented. APNs should also aim to conduct evaluations and research into cancer prevention and screening to build the currently limited evidence base and nursing knowledge in this important field.

COVID-19 Vaccine decision-making: trust among the transgender and disability communities in India

ABSTRACT Background Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. Methods Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. Results Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. Conclusion These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake.

Practice Makes Perfect: Objective Structured Clinical Examinations Across the UME-to-GME Continuum Improve Care of Transgender Simulated Patients.

Background Residents lack confidence in caring for transgender individuals. More exposure and practice throughout training is needed. Objective To explore whether and how prior exposure to transgender health skills during medical school impacted competency with these skills during residency. Methods In 2022, all 101 internal medicine residents at New York University Grossman School of Medicine participated in an objective structured clinical examination (OSCE) station as part of their annual formative assessment where they cared for a standardized patient (SP) who identified as transgender. Three SPs who were members of the transgender community were recruited through online and social media forums. Two resident groups (continuum vs noncontinuum) differed in their prior experiences with transgender OSCEs during medical school. We analyzed SPs' ratings of resident performance using checklist data and SP open-ended feedback to compare performance between groups and resident post-OSCE evaluations to understand residents' perceptions of the educational value of the case. Results Residents with prior experience with transgender SPs (continuum) were more frequently recommended by SPs (88% [21 of 24] vs 70% [54 of 77]) to a family member or friend, were all rated professional (100% [24 of 24] vs 94% [72 of 94]) and scored better in pain information-gathering (92% vs 65%, mean summary score) and gender-affirming care skills (67% vs 52%, mean summary score). Noncontinuum residents lacked experience, missed opportunities to ask about gender identity, and needed work on demonstrating comfort and using proper language. Most residents completing a post-OSCE evaluation (80%, 41 of 51) rated the case as "very valuable." Conclusions Spaced practice and feedback through early exposure to transgender OSCEs were valuable for skill acquisition, giving continuum residents a learning advantage compared to noncontinuum residents.

The trans gender subject of fashion

The T-girl is a trans feminine subject whose trans-ness is embodied sartorially in controlled environments for a short amount of time. Her trans-ness is not socially visible, her existential possibilities have accompanied the imbrication of digitality in everyday life and she escapes well-acknowledged trans feminine categories such as the Latin American travesti or the trans woman writ large. The T-girl is yet to be rigorously theorized. In this auto-theoretical psychoanalytic inquiry I propose to theorize her alongside her lovers by placing the sartorial as the de facto object of desire between them. The methodology involves culling from personal sartorial-sexual experience as well as the language around clothes found in private messages sent by trans-attracted and straight-identified men to the author, a T-girl. What does such an intimate archive tell us about the way the trans subject negotiates her desire with and through the other? Their sartorial exchanges serve as unprecedented insight into the intrapsychic mechanisms a trans subject deploys to forge a position for herself where the sartorial all but replaces the anatomical as the slippery guarantor of gender. I articulate the function of clothing in conjuring a trans-ness addressed to a ‘other’ interpellated to ratify the (trans-)gendering process. This turns out to be a rather primary dynamic that founds the speaking subject as such. And yet, the T-girl and her lovers may end up getting more than what they bargained for from their sartorial-sexual encounter. What becomes clear is the fundamental function of clothes not just to render the T-girl girl, but as exhilarating signifiers in the written and oral exchanges between the T-girl and her lovers. Particularly for the lovers themselves, who can be quick to slip from the position of the subject who enjoys feminine clothing in the other to that of the subject who enjoys wearing such clothing themselves.

SOCIO-ECONOMIC CONDITIONS AND SOCIAL ACCEPTANCE OF TRANSGENDER COMMUNITY: AN EMPIRICAL STUDY

Recent years have seen a significant increase in the prominence and attention given to human rights discussions and debates. Moreover, a lot of world leaders continue to yearn for the successful and complete implementation of their vision of a just society. In a variety of settings, a number of academicians, philosophers, and leaders have disputed this idealistic notion of creating a just society. They argue that a number of stratifying factors, such as caste, class, economic status, and family values, have long caused division in our society. With the passage of time, this stratified society changed and started fining the minority that was less fortunate more and more. Similarly, a sizable segment of the populace referred to as the transgender community has been perceived as a disadvantaged facet of society as a result of various forms of social stratification and certain inherent genetic deficiencies. The transgender community has been unable to exercise even the most basic constitutional rights that are granted to every person under the countrys constitution because of ignorance and inferiority complex. Members of the community have also been socially and economically excluded from society and have been unable to access government aid programs due to the gap created by the discrimination inside the community. Furthermore, transgender people are inadvertently reduced to the status of second-class citizens in a society guided by the constitutional ideals of liberty, equality, and fraternity because of a number of laws in the Indian context that only define Indian society in terms of male or female. The current study aims to comprehend the causes of the deprivations placed on transgender people in order to implement and formulate welfare measures specifically for the transgender community and enable its members to access constitutional and statutory mechanisms without facing any discrimination. It is imperative that we create practical measures immediately in order to lessen marginalization and make the transgender populations general socioeconomic growth a reality.

TRANSGENDERS’ RIGHTS IN ARGENTINA: REGARDING INDIA


 The transgender community has faced and continues to face discrimination in almost every part of the world. The inception, extent, and duration of such differential treatment coupled with violence may differ across the globe. The reason behind this could be the cultural and constitutional values of the concerned nation along with the traditional position of transgenders in the relevant society. The movement of LGBT community to assert their presence and voice their concerns can be traced in different countries. Argentina can be distinguished as a vanguard in the advancement of inclusive policies, notably with the passage of its Gender Identity Law in 2012, marking it as the inaugural nation worldwide to formally acknowledge an individual’s gender identity without imposing any prerequisites. This article provides a concise overview of the historical trajectory of the LGBT movement in Argentina, followed by an examination of the constitutional and legislative framework established to safeguard the rights of transgender individuals in the country. Subsequently, it delves into the enactment and notable attributes of the Gender Identity Law. It also provides a comparative analysis of transgender law in India vis a vis Argentina and criticises the contrasting approach followed by different States of India. It concludes with the finding that Argentina’s Gender Identity Law is quite progressive from which countries like India can take inspiration.

Food Insecurity and Mental Health Outcomes Among Transgender and Gender-Diverse Communities in the United States Post-COVID-19

A growing body of literature has shown that people in the transgender and gender-diverse (TGD) community have worse health outcomes than cisgender (cis) people, including higher rates of poor mental health. Additionally, during COVID-19, TGD persons experienced higher rates of food insecurity. In this article, we extend the literature by looking at new data in the post-COVID-19 period, a period of greater stability. Using data from the U.S. Census Household Pulse Survey (HPS), we explore the relationship between gender identity and health outcomes. The HPS began collecting data on gender identity of participants from July 2021. We analyze responses from 1.2 million survey participants between July 2021 and May 2023. Using an ordinary least squares regression model with state and week fixed effects, we show that, on average, TGD people are seven percentage points more likely to report experiencing food insecurity compared with cis persons. TGD persons also report more symptoms of depression (six percentage points) and anxiety (four percentage points) than cis persons. These results hold after controlling for the socioeconomic, demographic, and sexual identity characteristics of the individuals, suggesting that this gender identity imposes an additional cost that cannot be explained by social determinants of health. We find that health insurance and the Supplemental Nutrition Assistance Program do not provide very much protection to TGD individuals. In summary, our article suggests the need for safety nets that target specific contextual and institutional challenges faced by TGD communities to reduce health disparities across the country.

Evidence of Differences in Gender-Affirming School Experiences in a Sample of Transgender and Gender-Diverse Youth

Past and current research has often utilized a binary (ie, man/woman) category to measure gender and/or has combined multiple transgender identities into singular groups (eg, transgender girls and nonbinary youth as one category). However, transgender communities are heterogeneous and encompass much more than commonly recognized labels such as only transgender boys/girls and nonbinary youth. Furthermore, the small body of research that has investigated differences within transgender communities based on gender identity has found important health and behavioral differences. Using a large, national sample of transgender youth (N = 3,570), we investigated differences in health-relevant gender-affirming school experiences (ie, being referred to by the correct pronouns or name, authentic gender expression through clothing, and access to restrooms/locker rooms) among diverse transgender youth. Adjusted models (for outness, sexual identity, age, and caregiver education) indicated that transgender boys and transgender girls reported significantly worse gender-specific experiences in schools related to pronoun and chosen name use as well as access to restrooms/locker rooms compared with youth with nonbinary gender-diverse identities (eg, demigender and nonbinary), with some exceptions. Furthermore, transgender boys reported greater authentic gender expression through clothing relative to most other youth with nonbinary gender-diverse identities (eg, gender nonconforming and multiother). These findings have implications for how we might develop targeted interventions given that we pinpoint several disparities in health-relevant gender-affirming school experiences among transgender youth based on their specific gender identity. Finally, this provides stakeholders with a greater understanding of the extent of heterogeneity within transgender communities.

Perception in Uniform: A Study of Police Attitudes towards the Transgender Community in Pakistan

This study analyzes the complicated relationships between the police force and the transgender population in Pakistan. While laws like 2018's Transgender Persons (Protection of Rights) Act are a step in the right direction, the transgender population still faces prejudice and violence, including from those in positions of authority. Using quantitative surveys, qualitative interviews, and focus groups, this study provides a sequential explanatory mixed-methods analysis of police opinions. In the quantitative stage, police officers' cognitive, affective, and behavioral attitudes are measured with a structured questionnaire; in the qualitative stage, the reasons for these attitudes are explored using thematic analysis. An intersectional analysis is used to investigate the relationship between many social identities and police training and policy. Findings demonstrate a gap between policy and practice, impacted by cultural stigma, lack of proper training, and personal prejudices. In order to create a police force that is more welcoming to all members of the community, the study finishes with suggestions on how policy and training can be improved and how the public can become involved. This study adds to the ongoing conversation on human rights and policing by stressing the critical importance of instituting structural reforms to guarantee the safety and respect of all citizens, regardless of their gender identity.

Transgender and non-binary patient simulations can foster cultural sensitivity and knowledge among internal medicine residents: a pilot study

Transgender and nonbinary patients face unique healthcare challenges, such as harassment, discrimination, and/or prejudice, at higher rates than their cisgender counterparts. These experiences, or even the fear of these experiences, may push patients to delay or forego medical treatment, thus compounding any existing conditions. Such extraneous issues can be combatted through cultural sensitivity. The authors designed blended education consisting of an online module followed by a live simulation to educate and promote sensitivity. Internal medicine (IM) residents (n = 94) completed the module, which introduced them to transgender community terminology and medical disparities, and ways to incorporate affirming behaviors into their practice. Afterward, they engaged in a simulation with true transgender-simulated patients (SPs) — either trans-masculine, trans-feminine, or non-binary. Residents were expected to conduct a patient interview mirroring an intake appointment. Residents then engaged in a debriefing session with the lead investigator and the SP to reflect on the experience, receive feedback and constructive criticism, and ask questions. After the education, the residents’ knowledge significantly increased, t(66) = 3.69, p ≤ 0.00, d = 0.45, and their attitude toward members of the transgender community also increased significantly, t(62) = 7.57, p ≤ 0.00, d = 0.95. Furthermore, nearly all residents (99%) reported the training allowed them to practice relevant skills and was a worthy investment of their time. Nearly half (45%) of the residents who listed changes they will make to their practice pledged to ask patients for their preferred name and pronouns. Most comments were positive (75%), praising the education’s effectiveness, expressing gratitude, and reporting increased confidence. Results provided evidence that the education was effective in increasing IM residents’ knowledge and attitudes. Further research is needed to investigate the longitudinal effects of this education and to extend the education to a broader audience. The investigators plan to adapt and expand the research to other specialties such as gynecology and emergency medicine.

Digital health interventions for suicide prevention among LGBTQ: A narrative review.

Suicidal thoughts and behaviors (STBs) are prevalent within the Lesbian, Gay, Bisexual, Transgender, and Queers (LGBTQ) community, often exacerbated by challenges in accessing care and the perceived stigma and discrimination tied to disclosing one's identity. Digital health interventions that offer psychosocial self-help present a promising platform to reach individuals at risk of STBs, especially those who may not engage with conventional health services. This review aimed to assess the role of digital-based intervention in reducing STBs among LGBTQ individuals. We conducted a systematic literature search from three databases, PsycINFO, PubMed, and CINHAL, from 1st Jan 1990 to 31st December 2023. The review encompassed studies investigating the feasibility, acceptability, and impact of digital interventions on STBs, employing randomized control trials (RCTs), pseudo-RCTs, observational pre-posttest designs, and qualitative studies. Potential bias was evaluated using the McGill Mixed Methods Appraisal Tool (MMAT). Five non-overlapping studies were included, reporting data from 777 participants. The studies featured diverse types of digital interventions, including videos, online writing, and mobile applications. The studies included three RCTs, and two qualitative studies. Across most of these studies, notable enhancements or reductions in the proportion of participants reporting STBs were observed post-intervention, alongside improvements in help-seeking intentions. The findings underscored that the applications used in the studies were engaging, acceptable, and deemed feasible in effectively addressing suicide prevention among the LGBTQ community. Overall, digital interventions were found to be feasible and acceptable in suicide prevention among LGBTQ communities, demonstrating preliminary efficacy in increasing help-seeking behavior when experiencing suicidal thoughts and in reducing STBs. Therefore, advocating for widespread promotion and dissemination of digital health interventions is crucial, particularly in low- and middle-income countries (LMICs) with limited access to health services and heightened barriers to obtaining such services. Further research using fully powered RCT is imperative to assess the efficacy of these interventions.

Clinical and sociodemographic characteristics as predictors for quality of life in transmasculine and transfeminine individuals receiving gender-affirming hormone therapy

Healthcare systems and providers have increasingly acknowledged the role and impact of social determinants in overall health. However, gender-diverse individuals face persistent health disparities due to their identities. There is limited research on the impact of clinical and sociodemographic characteristics on mood and quality of life (QoL) for transgender (TG) individuals. Our study aims to understand and better elucidate social and clinical characteristics of transmasculine (TM) and transfeminine (TF) individuals and their impact on quality of life and depressive symptoms. In this cross-sectional study, 298 TF and TM individuals on gender-affirming hormone therapy (GAHT) were surveyed about their demographic characteristics (age, gender identity, body mass index (BMI), and education), social needs, mood, and quality of life. Multivariable regression modelling was performed to assess the effect of each variable listed above on three domains of QoL (psychological, environmental, and physical) as well as depressive symptoms. We find that QoL scores are similar between TM and TF individuals, with scores in the psychological domain particularly low in both cohorts. TM individuals report higher rates of stress and restroom avoidance than TF individuals. In particular, psychological well-being (measured by the psychological domain of QoL and depressive symptoms) is significantly associated with increased BMI, financial instability, and stress in TM individuals while for TF individuals, psychological well-being is associated with stress and social integration. These data suggest that social circumstances are key drivers of QoL and psychological well-being among gender-diverse individuals receiving GAHT with specific differences between TF and TM individuals. This information may be utilized by healthcare providers and policymakers to address and improve clinical care and social policies to improve health equity for gender-diverse individuals.

Hormone therapy and trans sexuality: A review.

Hormone therapy and trans sexuality: A review.

Strategies to Close the PrEP Uptake Gap Among Transgender People and Men Who Have Sex with Men in Tshwane, South Africa: Perspectives from the Community

HIV Pre-exposure Prophylaxis (PrEP) uptake among transgender (TG) people and gay men and other men who have sex with men (MSM) remains low, despite South Africa being the first African country to approve PrEP. This mixed-methods study used a two-phase explanatory sequential design: (1) quantitative analysis of cross-sectional surveys followed by (2) qualitative in-depth interviews. This study explored facilitators and barriers to PrEP uptake to identify strategies to increase utilization in these key populations. We conducted 202 cross-sectional surveys and 20 in-depth interviews between July 2021 and March 2022 in Soshanguve, Tshwane, Gauteng. Quantitative data were analyzed using univariate logistic regression; thematic analysis was performed for qualitative data. Findings show high willingness to use PrEP but low PrEP uptake. We outline strategies to facilitate PrEP use: (1) demystify daily PrEP by deploying community-engaged PrEP education campaigns; (2) capitalize on existing peer networks; and (3) expand accessible and culturally responsive PrEP service delivery models. We provide feasible recommendations to close the PrEP uptake gap in these key populations in South Africa.

Defining acceptable data collection and reuse standards for queer artificial intelligence research in mental health: protocol for the online PARQAIR-MH Delphi study

IntroductionFor artificial intelligence (AI) to help improve mental healthcare, the design of data-driven technologies needs to be fair, safe, and inclusive. Participatory design can play a critical role in empowering...

Experiences of transgender persons in accessing routine healthcare services in India: Findings from a participatory qualitative study.

Despite having a higher burden of health problems, transgender persons face challenges in accessing healthcare in India. Most studies on healthcare access of transgender persons in India focus only on HIV related care, mental healthcare, gender affirmative services or on the ethno-cultural communities or transgender women. This study fills this gap by focusing on diverse gender identities within the transgender community with a specific focus on experiences in accessing general or routine healthcare services. A qualitative descriptive approach was used in this study. 23 in-depth interviews and 6 focus group discussions were conducted virtually and in-person with a total of 63 transgender persons in different regions of India between May and September 2021. The study used a community-based participatory research approach and was informed by the intersectionality approach. Thematic analysis was conducted to analyze the data. Four key themes emerged: (i) intersectional challenges in accessing healthcare start outside of the health system, continue through cisgender-binary-normative health systems that exclude transgender persons; and at the interface with individuals such as health professionals, support staff and bystanders; (ii) the experiences negatively impact transgender persons at an individual level; (iii) in response, transgender persons navigate these challenges across each of the levels: individual, health system level and from outside of the health system. This is a first of its kind qualitative participatory study focusing on routine healthcare services of transgender persons in India. The findings indicate the need to move conversations on trans-inclusion in healthcare from HIV and gender affirmative services to routine comprehensive healthcare services considering the higher burden of health problems in the community and the impact of poor access on their lives and well-being.

Toward a Better Understanding of Cardiovascular Risk in the Transgender and Gender-Diverse Community: A Global Call to Action.

On World Heart Day 2022, the Mexican Society of Cardiology, the Inter-American Society of Cardiology, and the World Heart Federation collaborated on a public call to action regarding the increased risk of adverse cardiovascular health outcomes in transgender and gender diverse (TGD) individuals. The aim of this article is to unpack the numerous factors that contribute to this, such as the social stigma faced by members of the TGD community, their reduced access to clinical care, and the scarcity of research regarding the unique needs of their community, which makes it difficult for clinicians to provide individualized medical care. Decreasing the incidence of adverse cardiovascular events among TGD individuals requires interventions such as educational reform in the medical community, an increase in inclusive research studies, and broader social initiatives intended to reduce the stigma faced by TGD individuals.

NAVIGATING LEGAL IDENTITY: THE IMPACT OF LEGISLATIVE REFORMS ON TRANSGENDER RECOGNITION AND RIGHTS

This study examines how recent legislative changes have affected transgender rights and recognition, with a particular emphasis on the effects on social inclusion and legal identity. Examining how legislation pertaining to gender identification have changed over time in different jurisdictions, the research shows both progress and enduring difficulties. It looks at how laws might better support transgender people by increasing their legal recognition, preventing discrimination, and facilitating their access to necessary services. The success of these reforms in meeting the demands of the transgender community is also assessed in this report, and gaps where more legislative and policy changes are needed are highlighted. The results highlight the need for comprehensive legal frameworks and ongoing legislative lobbying in order to guarantee equality and safety for transgender individuals.

Readiness of Medical Students and Budding Doctors About the LGBTQ+ Community: A Cross-Sectional Study From India.

The Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning (LGBTQ) community has always faced discrimination across the globe. Due to a lack of information in medical curricula and no training or sensitization of doctors towards their health needs, there are numerous health disparities faced by this community. Negative attitudes and inadequate knowledge may also cause students to feel hesitant to treat patients in the community. The present study thus aims to evaluate the attitudes and knowledge of medical students and interns towards LGBTQ+. The present study is a cross-sectional observational study where a self-administered questionnaire was shared with the medical students of India via an online platform. The collected data was then analyzed using Microsoft Excel STATA version 14.0 (StataCorp LLC, Texas, USA). A total of 790 responses were analyzed. 67.2% of respondents had an overall positive attitude, with students under the age of 20, female students, and medical students being more likely to have a positive attitude towards the community. 60.7% of the respondents had satisfactory knowledge, with interns being more likely to have more knowledge than students. The respondents with better knowledge were more likely to have a positive attitude. The study participants had satisfactory knowledge, and the majority had a positive attitude towards the LGBTQ+ community. However, to clear misconceptions regarding the LGBTQ+ community, the medical curriculum must be updated to include more information and provide proper training and sensitization in order to ensure optimum healthcare for all, regardless of sexual orientation and identity.

Characterizing Chronic Pain and Adverse Childhood Experiences in the Lesbian, Gay, Bisexual, Transgender, or Queer Community.

Childhood adversity is associated with chronic pain in adulthood. Additionally, individuals identifying as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) report a greater prevalence of chronic pain and increased adverse childhood experiences (ACEs). While the LGTBQ+ community has a disproportionately high chronic disease burden, limited research has been conducted on the associations between chronic pain conditions or intensity and childhood adversity in this population. In this cross-sectional study, participants were 18 years or older, LGBTQ+ identifying, and reported chronic pain. Surveys were electronically distributed from August to November 2022 via LGBTQ+ organization email listservs and social media platforms. The survey included demographics and validated questionnaires measuring chronic pain (The Chronic Pain Questionnaire) and childhood adversity (ACE score). In analysis, ACE scores of 4 or more were defined as high. Responses from 136 individuals (average age of 29 ± 7.4 years) were analyzed. The mean for participants' average pain rating in the last 6 months was 5.9 of 10. Participants' worst pain was rated at least a 7 of 10 for 80% of respondents. Half (47%) had high ACE scores, and high ACE scores were significantly associated with higher average pain scores (6.27 ± 1.79, mean difference = -2.22, P = .028, 95% confidence interval [CI], -1.2 to -0.0), and higher perceived current pain ratings (4.53 ± 2.16, mean difference = -2.78, P = .007, 95% CI, -1.9 to -0.3). Transgender and gender diverse (TGD) participants (n = 75) had higher ACE scores (3.91 ± 1.78) and current pain scores compared to cisgender individuals (3.9 ± 1.8 vs 3.0 ± 1.9, P = .009, 95% CI, 0.0-0.3). History of any sexual trauma was prevalent in 36.7% and was associated with chronic pain located in the pelvic region ( P = .016, effect size estimate 0.21). Specific histories of forced sexual and touch encounters were associated with a specific diagnosis of fibromyalgia ( P = .008, effect size estimate 0.31 and P = .037, effect size estimate 0.31, respectively). Childhood adversity and chronic pain's dose-dependent relationship among our LGBTQ+ sample indicates a need to explore trauma's role in perceived pain. Given sexual trauma's association with pain location and diagnosis, type of trauma may also be crucial in understanding chronic pain development. Research into the relationships between childhood adversity, sexuality, gender identity, and chronic pain could improve chronic pain prevention and management for the LGBTQ+ community.