Exploring the perspectives of Canadian Veterans and service members on the impacts of sex and gender on their chronic pain experiences

Introduction: Since sex and gender factors influence injuries in military populations, it can be expected that they would influence the health journeys of Veterans. The purpose of this study was to explore the experiences of Canadian Veterans in perceived risks of chronic pain and related health care experiences, focusing on sex differences and gendered factors. Methods: Twenty-six Canadian Veterans (11 women, 15 men) living with chronic pain participated in interviews. One coder performed the thematic description following interpretive description methods. Results: Ten Veterans reported that sex and/or gender influenced their risk of developing chronic pain, while 16 Veterans highlighted its impact on chronic pain treatments. Five themes were developed: 1) sex differences contribute to different injury risk profiles, 2) the culture of stoicism in the military impacts men and women, 3) women have elevated chronic pain risk due to gender discrimination, 4) quality of care can be compromised when health care providers, the military, and Veterans Affairs Canada do not demonstrate an understanding of chronic pain, and 5) Veterans experience other forms of discrimination that impact their chronic pain experiences. Discussion: Sex differences in body structure and physiology may require sex-specific training and equipment. The retention of military culture of stoicism is a barrier to self-management as Veterans transition to civilian health care system, a problem that is further exacerbated by lack of awareness of their chronic pain by civilian health care providers. Reducing the burden of chronic pain requires changes not only during service, but also in the civilian health care system.