Advance-CTR

Advance RI-CTR New Discovery Award

"The impact of intersectional race and gender (beyond the binary) biases in pain perception"

There is a shortage of research examining the intersection of race (beyond Black and White patients) and gender (beyond cisgender) on biases in pain perception and treatment. Therefore, the purpose of the current research is to examine biases in pain perception and treatment recommendations for cisgender and transgender racially diverse patients by perceivers who also vary in race and gender.

The proposed project will be the first to focus on a diverse sample of perceivers who vary in race (White vs. people of color) and gender (cisgender vs. TGNC). Perceivers will be randomly assigned to a vignette about a person in pain who varies in race (Black, White, Hispanic, Asian) and gender (cisgender woman, cisgender man, transgender woman, transgender man, and gender nonconforming person). After reading the vignette, perceivers will be asked to make judgments about the person’s pain level, pain authenticity, and treatment recommendations. Pain perception and treatment biases will be examined by running a series of 2 (perceiver race: White vs. people of color) X 2 (perceiver gender: cisgender vs. TGNC) X 4 (patient race: Black, White, Hispanic, Asian) X 5 (patient gender: cisgender woman, cisgender man, transgender woman, transgender man, and gender nonconforming person) Analysis of Variances (ANOVAs) with the following 3 dependent variables: pain perceived, pain authenticity, and treatment recommendation.

It is hypothesized that there will be a significant interaction of patient race and patient gender such that those who hold multiple marginalized identities, will have their pain perceived lower, their pain authenticity questioned more, and be recommended less treatment compared to those from one marginalized identity or no marginalized identities. Additionally, this interaction will be moderated by perceiver race and gender such that perceivers who hold multiple marginalized identities will be less likely to hold these biases compared to those who hold one or no marginalized identity. 

This research has the potential to uncover biases in pain care that are still not known among TGNC patients and examine the moderating role of perceiver gender race. These data will inform future interventions aimed at reducing pain perception biases and ultimately pain treatment disparities by providing more equitable pain care for marginalized patients, thus decreasing suffering and improving quality healthcare. This study addresses clinical and translational research on pain disparities that underserved populations in Rhode Island face including Latinx populations. In addition, this work will support the development of a K award which if funded will allow for the collaboration of faculty at Brown Medical School and URI.