Chronic pelvic and related genital pain in transgender and gender-diverse people: a scoping review.

Authors

Ragav Chona, Sami G Sabbah, Marina Englesakis, Tania Di Renna, Olivia Drodge, Brittany N Rosenbloom, Mathew Leonardi, Gianni R Lorello

Published in

EClinicalMedicine. Volume 101. Pages 104252. Epub Oct 06, 2026.

Abstract

Chronic pelvic pain (CPP) and related genital pain are disabling and multifaceted, but understudied in transgender and gender-diverse (TGD) people.
In this scoping review, we mapped evidence on prevalence, aetiology, assessment, and management across gender-affirming hormone therapy (GAHT), surgical, and community contexts. Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidance, we searched ten databases from database inception to 30 July 2025, supplemented by citation chasing, and including primary-data reports of duration-defined CPP (persistent or recurrent pelvic pain for at least three months) or related pelvic and genital pain within a broad chronic pain framework. The search protocol was registered prospectively on the Open Science Framework (osf.io/mk6cp). Two reviewers independently screened records and extracted published data.
24 reports representing 23 unique cohorts and 5527 TGD participants were included. Only one study explicitly estimated duration-defined CPP prevalence, reporting 17·7% among TGD adults assigned female at birth. Broader pelvic and genital pain outcomes ranged from 9·6% to 72·2% across five studies, but should not be interpreted as duration-defined CPP prevalence. Four non-mutually exclusive domains were identified: hormonal and tissue-mediated, pelvic floor and musculoskeletal, surgical and anatomical, and psychosocial and trauma-related. Assessment and diagnostic pathways were heterogeneous. Management evidence was very limited and derived almost entirely from observational studies, programme audits, and case reports; only one short randomised trial evaluated an intervention.
Our findings support gender-affirming, multidisciplinary evaluation while highlighting the need for standardised CPP definitions, validated TGD-specific patient-reported measures, prospective cohorts, and adequately powered interventional trials.
None.

PMID:
42893217
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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