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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 They Say About Us

  • Testimonials

    • Testimonial by Rosanna R., age 35

      Heather has affected my life in the MOST POSITIVE way and I am forever grateful.  My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.  After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone.  They...

      Read more Testimonial by Rosanna R., age 35

  • Testimonials

    • 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...

      Read more Testimonial by J.B.

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