Risk and protective factors related to sexual orientation disparities in chronic pain among youth

Chronic pain affects a substantial proportion of the U.S. population.  We investigated risk and protective factors related to sexual orientation disparities in chronic pain frequency among youth.  We used data from 9032 females and 8462 males, grades 7-12 (mean age at Wave I=16.12 years), from Waves I-IV of the National Longitudinal Study of Adolescent Health. We examined sexual orientation identity (completely heterosexual, mostly heterosexual, bisexual, lesbian/gay), chronic pain frequency (past year), child maltreatment (before 6^th grade), depressive symptoms (past week), suicidality (past year), social support (current), and self-esteem (current).  Longitudinal ordered logistic GEE models, stratified by gender, controlling for sociodemographics, tested whether sexual orientation predicted headache and stomachache frequency (weekly vs. rarely).  Models with sexual orientation only were compared to models adding risk and protective factors.  Among females, mostly heterosexuals were more likely to report weekly headaches (OR=1.30) and stomachaches (OR=1.28), and lesbians were more likely to report weekly headaches (OR=1.80), than completely heterosexuals.  Among males, mostly heterosexuals and gay males were more likely to report weekly headaches (mostly heterosexual OR=1.47; gay=1.77), than completely heterosexuals.  Sexual orientation disparities in headaches (females and males) and stomachaches (females only) were attenuated by as much as 19.8% and became non-significant when controlling for child maltreatment, depressive symptoms, suicidality, social support, and self-esteem.  Sexual orientation disparities in chronic pain were partially explained by risk and protective factors.  More research is needed to explore additional drivers of these disparities in females and males to inform efforts to prevent excess chronic pain in sexual minority youth.