Gender-Affirming Care

At Healthy Pelvis Physical Therapy, we understand that everyone has a pelvis, making pelvic floor dysfunction and related issues a possibility for anyone. Our commitment lies in fostering an inclusive and supportive atmosphere, ensuring that all individuals receive personalized care designed to meet their unique needs.

Pelvic floor physical therapy plays a vital role in supporting the transgender and gender non-conforming community, addressing both surgical and non-surgical methods they might adopt. Non-surgical or pre-surgical practices include binding for trans men, and tucking and packing for trans women. Physical therapy is essential in ensuring safe binding practices to prevent chest, shoulder, and back pain, numbness, scarring, and to maintain proper posture. For trans women using packing or tucking, physical therapy provides guidance to prevent gait irregularities and muscle dysfunction in the lower extremities.

In cases of gender-affirming surgeries, pelvic floor physical therapists are instrumental in alleviating pain from surgical scars, facilitating or enhancing neovaginal penetration during sexual intercourse, improving the ability to achieve orgasm, restoring normal urinary function, and resolving pelvic pain. The safe commencement of physical therapy typically occurs around eight weeks post-surgery, but this timeframe can vary depending on the specific surgical procedure undertaken.

Symptoms

• Discomfort arising from surgical scars

• Pain during vaginal penetration

• Challenges or inability to achieve vaginal penetration

• Difficulty in achieving orgasm, or complete inability to do so

• Urinary issues, such as urgency, frequent urination, hesitancy, incontinence, and spraying

• Pain in the pelvic area

• Pain in the chest and back regions

• Pain in the shoulders

Causes

• Scarring from surgery

• Neovaginal stenosis

• Reduction in neovaginal depth

• Pudendal nerve pain

• Ongoing granulation tissue issues

• Dysfunction of the pelvic floor

• Compression-related concerns

• Dysfunction in the muscles of the lower extremities

• Issues with posture

What to expect

At your initial appointment, we will start by taking your medical history, followed by a comprehensive musculoskeletal examination of your pelvic area. This will include assessing your posture, joint alignment, any muscle restrictions or trigger points, the health of your connective tissue, and muscular strength. An internal examination is often part of this process, but it's entirely optional and will only be conducted if you feel completely comfortable with it. This exam is much more relaxed and comfortable compared to a typical ob/gyn/urologist visit, and it provides essential information about your pelvic muscle tone, strength, and coordination. If impairments are found during the exam, the physical therapist can treat the problems with manual therapy techniques resulting in pain relief and improved function. Following the exam, we'll discuss our findings with you and outline a personalized treatment plan aimed at achieving the best results. Most patients start feeling better after their first session and see significant improvement by their third visit.