Sex, Hormones and Identity affect Nociceptive Expression (SHINE)

性别、荷尔蒙和身份认同影响伤害性表达(SIRE)项目摘要 经常有报道称，女性比男性表现出更低的痛阈值和更高的敏感度 实验性疼痛测试。然而，“性”和“性别”经常被交替使用来描述这些 差异，但基因性别和性别认同并不总是一致的。因此，人类受试者可能是 根据基因性别被归类为男性或女性，即使他们不认为自己是男性或女性， 分别进行了分析。变性人(TM和TW)是一个少数群体，他们的性别认同是 与他们的基因性别不同(相对于顺性男性和女性；CM和CW)。因此，TM和 TW可能会经历耻辱、偏见和抑郁，这会使他们面临更大的负面健康后果风险 并影响了生活质量。因此，这个未被研究的社区提供了一个独特的机会来调查 性别认同的作用(变性与顺式)、出生时的性别分配(男性与女性)和荷尔蒙状态(升高) 睾丸激素与雌激素升高)对疼痛和幸福感的影响，同时提供对需求的更好理解 社区中的一员。本研究的具体目的包括：1.确定性别认同、性别分配的影响 出生时和荷尔蒙状态对疼痛敏感。2.研究社会和心理因素对 在我们的团队中对疼痛敏感。3.为了量化我们之间免疫细胞群体和活性的差异 组。在当地社区利益相关者的协助下，我们将招募以下小组：CM、CW、TM T (目前正在服用外源性睾酮)、TW E(外源性雌二醇)、TM和TW(n=20个/组)。我们将使用 定量感官测试，通过标准化方案评估对冷、压和热的敏感性。血样 样本将被用于评估压力和生殖激素水平，免疫细胞数量和 刺激细胞因子的释放，以及唾液样本，以衡量应激反应。最后，调查问卷将 测量疼痛状态，生活质量，声音生活质量，身体形象，外表，自我报告健康， 男性/女性，社区连通性，性别角色，睡眠，抑郁，社会支持，不利 童年经历和耻辱。总而言之，这将是第一次探索性别认同、性别 出生时和荷尔蒙状态对生活质量、疼痛敏感性和免疫细胞活性的影响 个人。这项调查还将提供与服务不足的人的需求有关的关键信息 对人口的研究严重不足。

Sex, Hormones and Identity affect Nociceptive Expression (SHINE)Project Summary It is often reported that females demonstrate lower pain thresholds and higher sensitivity than males in experimental pain tests. However, “sex” and “gender” are often used interchangeably to describe these differences, but genetic sex and gender identity are not always congruent. As a result, human subjects may be categorized as male or female based upon genetic sex even if they do not identify as a man or woman, respectively. Transgender (trans) men and women (TM and TW) are a minority group whose gender identity is different than their genetic sex (as opposed to cisgender men and women; CM and CW). As a result, TM and TW may experience stigma, prejudice and depression, putting them at greater risk for negative health outcomes and impacted quality of life. Thus, this understudied community provides a unique opportunity to investigate the role of gender identity (trans vs. cis), sex assigned at birth (male vs. female) and hormonal status (elevated testosterone vs. elevated estrogen) on pain and well-being, while providing a better understanding of the needs of the community. Specific aims of this study include: 1. To determine the impact of gender identity, sex assigned at birth and hormone status on pain sensitivity. 2. To examine social and psychological factors to contribute to pain sensitivity in our groups. 3.To quantify differences in immune cell populations and activity between our groups. With the assistance of local community stakeholders we will recruit the following groups: CM, CW, TM+T (currently taking exogenous testosterone), TW+E (exogenous estradiol), TM, and TW (n=20/group). We will use quantitative sensory testing to assess sensitivity to cold, pressure, and heat via standardized protocols. Blood samples will be taken for assessment of stress and reproductive hormone levels, immune cell populations and stimulated cytokine release, as well as salivary samples to measure stress reactivity. Finally, questionnaires will measure pain state, quality of life, voice quality of life, body image, appearance, self-reported health, masculinity/femininity, community connectedness, gender role, sleep, depression, social support, adverse childhood experiences and stigma. Together, this will be the first exploration of the impact of gender identity, sex assigned at birth and hormonal status on quality of life, pain sensitivity and immune cell activity in trans individuals. This investigation will also provide critical information with respect to the needs of this underserved and critically understudied population.