Author ORCID Identifier

https://orcid.org/0000-0002-8249-4854

Semester

Summer

Date of Graduation

2026

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Christina L. Duncan

Committee Member

Kevin Larkin

Committee Member

Elizabeth Claydon

Committee Member

Ryan Best

Abstract

Sexual minorities with chronic pain are likely to experience stigma stemming from their sexual identity and chronic pain. Pain stigma and sexual minority stigma are associated with increased health disparities and differences in health care utilization, particularly for adults. The transition to the adult health care system appears to be a critical point to understand the impact of stigma on health care utilization to then improve outcomes. With a sample of 48 sexual minority young adults with chronic pain, the current study investigated transition experiences using an explanatory, sequential mixed-methods design that was both observational and cross-sectional. Participants completed quantitative measures (sexual minority stress, pain stigma, health care utilization, pain characteristics, and demographics) and a sub-sample participated in qualitative interviews. Descriptive statistics showed that despite many participants experiencing stigma in medical settings (31.3% related to sexual identity; 63.8% related to pain), a majority of participants (72.9%) transitioned to adult health care for pain management. A multiple logistic regression examined the relations between pain stigma, sexual minority stigma, and transition status, with pain invalidation by health care professionals and by immediate others emerging as significantly, negatively associated with transition. Qualitative interviews regarding experiences of stigma and the transition process resulted in four themes: experiences of dismissiveness, intersection of stigma, transition out of necessity, and the importance of affirming care. Qualitative findings were integrated with quantitative results using a triangulation protocol. The results suggest that experiences of pain stigma from health care professionals remains an important variable in understanding barriers to transition.

Download

Share

COinS