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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.

What Our Patients Have to Say

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Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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