Intersecting burdens: Gendered racism, bodily pain, and mental health in Black women.

OBJECTIVES

Black women experience disproportionate burdens of pain and pain interference. Emerging evidence identifies gendered racial microaggressions (GRMs) as a social determinant of health linked to psychological distress. However, to our knowledge, no research has quantitatively examined how GRMs relate to Black women's physical pain experiences while accounting for mental health.

METHOD: Multivariable ordinal logistic regression was used to investigate 415 Black women's experiences of GRMs, bodily pain, and pain interference. The present study explored whether these relationships persisted after controlling for symptoms of depression, anxiety, stress, and trauma.

RESULTS

Consistent with hypotheses, greater exposure to GRMs was associated with more intense bodily pain and greater pain interference. Among GRM dimensions, the Angry Black Woman Stereotype demonstrated the strongest relationship to both pain intensity and pain interference, suggesting that internalized gendered racial stereotypes may exacerbate pain experiences through mechanisms such as self-silencing or distrust in health care settings. Notably, these relationships remained significant after accounting for mental health, indicating that GRMs independently relate to pain outcomes. Poor mental health also partially attenuated the relationship between GRMs and pain interference, suggesting possible bidirectional pathways between psychological distress and pain.

CONCLUSIONS

Gendered racism is a critical yet underrecognized factor in Black women's pain experiences. Addressing this intersectional stressor requires trauma-informed, culturally responsive, and systemically aware approaches to assessment and treatment. Clinicians must integrate mental health screening into pain management for Black women, whereas researchers and policymakers should prioritize interventions and reforms that mitigate intersectional structural inequities contributing to pain disparities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).