The Importance of Minority Stress and Intersectionality for Cancer Symptom Management: The Case of Cancer-Related Pain.

Although research demonstrates that cancer survivors who are sexual and gender minorities (SGM), racial and ethnic minorities, or of lower socioeconomic status experience a higher prevalence of cancer-related pain, limited studies have examined how these intersecting marginalized identities and additional social experiences interconnect and affect pain outcomes. In their recent study, Boehmer and colleagues conducted an intersectional analysis of cancer-related pain among SGM adults and other marginalized backgrounds. Using data from the Behavioral Risk Factor Surveillance System, they found that SGM individuals reported a higher prevalence of cancer-related pain. SGM adults with a history of cancer who were younger than 65 years, Black or Hispanic, had low income, unemployed, never or formerly married, and reported poor access to care demonstrated higher likelihood of pain prevalence than their heterosexual cisgender counterparts. In this commentary, we explore minority stress, defined as the socially based and chronic stress associated with stigma, fear of discrimination, and prejudice, as a possible contributing factor to this higher prevalence of pain among those with intersecting marginalized identities, through its effect on biological function and symptoms. The findings of Boehmer and colleagues' study underscore the need to further explore intersectional approaches to pain management in cancer care and research. See related article by Boehmer et al., p. 1309.