quincunx tend to cause bit of health strain or need adjustments made in life. As its a ‘generational planet’ you not even feel it, especially if its above the horizon.
“Chiron – Pluto: The native blessed (or cursed) with this combination is intense, dramatic, profound and deep. There can be deep and hidden scars from childhood that either strengthen or break the individual later in life. Stressed, there can be huge struggles throughout life, and there is a virtual certainty of some form of childhood abandonment or rejection. If you have this placement, there are two keys to healing: Know yourself, and find a way to turn your own pain into a tool to heal others” http://www.aquarianage.org/west/planets/ch-nat02.html
I think this aspect is not significant until the thirties, maybe even late thirties. Chiron will raise psychological issues around discomfort with sex, and it will stimulate the need in the native to search own health solutions primarily through studies. Since its a generational aspect, when triggered by an aspect such as Chiron Return , it will produce interesting social trends.
According to Barbara Hand Clow and her book “Chiron-Transforming Bridge Between the Inner and Outer Planets” “Chiron quincunx Pluto creates an incessant drive to find the deepest level of meaning in any situation. The nagging prodding of Chiron to Pluto or Pluto to Chiron will either drive the native into imbalance, or push them into developing Chirotic powers with which to explore the Underworld. This seems to be a very karmic aspect which may be blocked until the parent related to the natal Pluto dies or transforms. There is often a death that releases a native with Chiron quincunx Pluto, because the parent blocking Pluto must release the tension of the quincunx so that this native is free to join his or her own peer group.”