Gender Affirming Care at Femina Physical Therapy
What is Gender Health and Gender Affirming Care?
Gender health is a spectrum of multidisciplinary treatments specifically related to a person’s gender. More commonly these treatments are called gender affirming care. Anyone can benefit from gender affirming care, but the term is most commonly associated with transgender and nonbinary people. We’ll outline how our PT services can help those individuals below.
When people think of gender affirming care, they will most commonly think of hormones or surgery. Both of those treatments bring changes to the body that sometimes need to be managed with rehabilitation services. Consultation with a physical therapist can help someone prepare for surgery by improving strength and conditioning. Physical therapists can also support someone recovering from gender affirming surgery. There are several surgical programs, such as OSHU and NYU Langone that have incorporated pelvic floor physical therapy as pre/post surgical care.
Physical therapists can support transgender people that don’t plan to have surgery, or are only on hormone replacement therapy. Changes in urinary and sexual function are common in trans women using estrogen replacement therapy. Pelvic floor physical therapy can help strengthen muscles, improve blood flow, decrease pelvic pain, and address changes in urinary function. Physical therapists can also create custom exercise plans to help reshape the body while improving overall health. 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 orthopedic physical therapists. Physical therapists can be involved to help support someone’s transition in a variety of ways to help support specific needs:
Nonoperative Gender Affirming Pelvic health and Orthopedic Assessment:
- Alignment, postural assessment and corrective exercises –
- Binding can lead to postural or breathing changes 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. This is also true when delaying urinating due to lack of safe bathroom access.
- Managing pain and dysfunction associated with hormonal changes to pelvic organs.
- Hormonal changes can be associated with changes in sexual and urinary function in anyone. Pelvic PT can provide interventions to help manage pain and improve urinary and sexual function.
- Orthopedic Pain management – Anyone can experience orthopedic pain regardless of gender or transition. Everyone deserves safe affirming care.
- Pregnancy, birth prep, and postpartum rehab – Trans men and transmasculine people become pregnant too and need just as much support as cisgender women. Pelvic floor physical therapists can help with pain management, safe exercise, preparation for labor and delivery, and postpartum care.
Preoperative Gender Affirming Pelvic Health and Orthopedic Assessment:
- Orthopedic Pain management – Anyone can experience orthopedic pain regardless of gender or transition. Everyone deserves safe affirming care.
- Pregnancy, birth prep, and postpartum rehab – Trans men and transmasculine people become pregnant too and need just as much support as cisgender women. Pelvic floor physical therapists can help with pain management, safe exercise, preparation for labor and delivery, and postpartum care.
- Fascial mobility assessment – to help with skin graft harvesting
- Shoulder mobility assessment prior to top surgeries (transmasculine or transfeminine)
- 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 and/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.
- Mobility assessment – overall mobility can help you care for yourself following surgery. PT can help make sure you have the range of motion to dilate as comfortably as possible.
- Patient-specific education: This is an essential component of any physical therapy treatment plan
Postoperative Gender Affirming Pelvic Health and Orthopedic Assessment:
- Post-surgical edema and pain management
- Post-surgical care can pick up where the plan of care left off by continuing to address postural and orthopedic dysfunction, and identify and address post surgical 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 which are important for chest masculinization surgery, any bottom surgery, Feminizing Mammoplasty
- Dilator training after bottom surgery or persistent pain
- Improve sexual and pelvic health
Why Choose Femina PT for Gender Health Physical Therapy?
At Femina PT, we are dedicated to providing safe, affirming care tailored to the needs of the transgender and nonbinary community. Our therapists are experienced in both pelvic health and orthopedic care, ensuring comprehensive support before and after surgery. As part of our commitment to inclusivity, we also hire members of the LGBTQIA+ community to better serve our patients.
At Femina Physical Therapy, we offer expert care for gender health, pelvic health, and orthopedic needs. Schedule an appointment today to learn more about how we can support your transition and recovery.
**This information is for educational purposes only and is not intended to replace the advice of your doctor.**