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Transgender Physical Therapy Services

Transgender patients that are prepping for, or have undergone gender confirmation surgery (also termed gender affirmation surgery), will require the services of compassionate and skilled pelvic health and orthopaedic physical therapists. Here are some of the more common ways a physical therapist can be integrated in to their care:

Preoperative Pelvic Health and Orthopaedic Assessment:

  • Alignment, postural assessment and corrective exercises –
    • Binding can lead to postural dysfunctions that in turn lead to neck and back pain.
    • Tucking is associated with changes in bladder function due to long periods of delay/retention and puts you at increased risk of developing overactive pelvic floor muscles.
  • Fascial mobility assessment – to help with skin graft harvesting
  • Hip mobility assessment – decreased range of motion can lead to difficulty in positioning during the surgery, or increased pain postoperatively if hips placed into already restricted position due to extensive time spent in position during surgery (6-8 hours); Communication with the surgeon on these limitations for possible position alterations to decrease time spent in restricted or painful range of motion
  • Functional core assessment: weakness, overactivity or incoordination of abdominal and pelvic floor muscles contributes to bladder, bowel and sexual dysfunction. Some of this dysfunction may be present preoperatively and should be assessed and treated to improve post-operative outcomes.
  • Patient-specific education: This is an essential component of any physical therapy treatment plan

Postoperative Pelvic Health and Orthopaedic Assessment:

  • Continue to address postural and orthopaedic dysfunction found preoperatively, and reevaluate for changes in status, including strength, muscle flexibility and joint range of motion
  • Evaluation and treatment for bladder, bowel and sexual health when appropriate (urinary urgency, painful intercourse, perineal itching, burning sensation, incontinence or leakage or any other discomfort in abdominal, genital or perineal area that may be present).
  • Scar tissue management and myofascial therapies for FtM chest masculinization surgery, FtM and MtF bottom surgery, MtF Feminizing Mammoplasty
  • MtF--dilator training and support; sexual health and improve function
  • FtM-sexual health and improve function

The transgender population needs the support of our community, and from a young age. Gender identity, gender expression and sexual orientation as portrayed by society may conflict with how adolescents are perceiving themselves. This can have devastating consequences, including suicide. The transgender population has an alarmingly high suicide rate – 41% at some point in their lives, compared with 4.6% of the general population (from American Foundation for Suicide Prevention and the Williams Institute from results analyzed from the National Transgender Discrimination Survey). Providers need to educate themselves and be sensitive to these challenges that are faced.

At Femina Physical Therapy, while focusing on pelvic health, offer chronic pain therapies for the entire body. Our main goal is to create a healing and supportive environment that is welcoming to all. We look forward to seeing you soon.

**This information is for educational purposes only and is not intended to replace the advice of your doctor.

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What Our Patients Have to Say

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

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