So this is 20" chain but can be resized to 22"?

yes, the chain is 20 inches long, with a 2 inches chain extender.

What do the letters on the back stand for? Does it say St. Benedict anywhere on the medal?

The letters on the back are specific to St. Benedict and the prayer. Additionally, if you research the letters, positions and the prayer you will see it is specific to St. Benedict.

Is this price comes in 2 pcs (men and women) when puchased?

It comes with the medal and a nice thick chain. More of a man's chain. I buy the blue medal and wear it on a different chain and gifted the thicker chain to my son.

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