Meet Dr. Tania Di Renna

Chronic pain disproportionately affects women and gender-diverse people. Yet, longstanding gaps in research mean that diagnostic models and treatments often fall short for them.

Dr. Tania Di Renna spoke with us about the consequences of those gaps, the power of interdisciplinary care and why she believes we are finally turning a corner.

A recent article from CBC highlighted that pain research has long overlooked sex and gender, leading to generalized clinical recommendations that may not be suitable for everyone. From your view as the leader of the Toronto Academic Pain Medicine Institute (TAPMI), how does this research gap translate to clinical care and outcomes?

The research gap around sex and gender in pain is very real in Canada, and we feel it in clinic every day. Many women come to us after years of not feeling heard. Historically, most pain research was done in male populations. From 1977 to 1993 women and female animals were excluded from most trials in the US. This led to us being decades behind in research around diagnosis and therapies. What happened is that we used a default male model and this just doesn’t work. Pain isn’t one-size-fits-all. Most people who experience chronic pain conditions are women and gender nonbinary people. This means that the diagnostic models and drugs we use to manage pain don’t work on us.

Canadian data consistently shows women live longer but spend more years in poor health, much of that driven by chronic conditions like pain. McKinsey’s global women’s health analyses estimate that closing women’s health gaps could add years of healthy life and significant economic value, and pain is a major contributor.

In practice, it means delayed diagnoses, under-treatment, and a heavier chronic pain burden for women. For gender non-binary people, the gap in evidence for pain care is even more disproportionate.

TAPMI is the only comprehensive, interdisciplinary academic pain program serving as the hub for chronic pain care in Toronto. How does that model allow you to address these kinds of sex- and gender-based disparities that are missed in more siloed approaches to pain care?

Pain cannot be siloed. It sits at the intersection of biology, trauma, hormones, mental health, and social context. This is why interdisciplinary care is essential.

At TAPMI, we bring psychologists, physiotherapists, and educators together around shared care pathways. The health disciplines involved in pain care are an absolute essential part of people learning how to manage pain. In our orientation session, people are given the opportunity to enroll in many group based interdisciplinary psychosocial programs targeted to pain management.

When you take a coordinated approach, you start to see different outcomes. You validate lived experience and we can you to correct some of the structural biases that built up over decades.

Earlier in your career, you founded Ontario’s first Multidisciplinary Female Pelvic Pain Clinic, a bold move at a time when women’s pain conditions were under-resourced. What motivated that initiative and how has the landscape shifted since then?

Starting the multidisciplinary pelvic pain clinic came from a place of frustration and compassion. I had created a similar program in Ottawa with Dr. Sony Singh in Ottawa and when I moved to Toronto, I was still seeing women with severe, life-altering pain who had done everything “right” but still had no coherent care plan. Even in one of Canada’s largest cities, it felt like the system wasn’t built for the realities they were living.

At the time, pelvic pain was often dismissed as niche. Today we understand it as a major public health issue. Awareness has grown. Research is expanding. There’s more advocacy than ever before. But access to imaging, surgery and multidisciplinary care still hasn’t caught up to need.

I’m really proud to say that we’ve moved from invisibility to recognition and the the next step is scaling care, so recognition translates into access.

Women’s College Hospital has an explicit mandate around health equity. How does that value shape the way TAPMI serves its patients?

Women’s College Hospital has a deep commitment to equity, and that shapes everything we do.

For TAPMI, that means designing pathways with gender, trauma, socioeconomic barriers, and cultural safety in mind. It means a central triage, so patients don’t get lost in referral loops and get placed in the shortest line ups. Having our central intake allows us to see the gaps in programing so we can build them intentionally for populations who have historically been overlooked, including women, gender-diverse people, and those living with complex pain.

For patients who have spent years feeling dismissed about their pain – something that disproportionately affects women and marginalized groups – what does WCH and TAMPI offer that gives you hope we are moving in the right direction?

Many patients come to us carrying years of dismissal. Not just untreated pain, but the emotional weight of not being believed. This takes a toll on mental and physical well being as the mind and body are connected. One of the most powerful things we can offer is validation. Being heard can be the first step toward healing.

What gives me hope is that the conversation is changing and patients are not only speaking up, but being heard. Research is catching up. Nationally, there’s growing recognition that women’s pain has been underestimated for too long. The Canadian Institutes of Health Research have earmarked a significant amount of funding to explore women’s health issues over the last year. TAPMI has obtained a significant grant to support the early diagnosis of endometriosis. Even large economic analyses like McKinsey’s are highlighting how closing women’s health gaps benefits entire societies.

At TAPMI and Women’s College Hospital, we focus on rebuilding trust through interdisciplinary care and true partnership with patients. We’re not finished yet, but we are moving from a culture of dismissal to one of listening. And that shift is profound.