Gender-Affirming Pelvic Health Physical Therapy

Pelvic floor physical therapy can help with bladder and bowel symptoms, pelvic pain, pain with sexual activity, pelvic floor tension, and changes in strength or coordination. We can also address physical concerns related to binding or gaffing and provide support before or after gender-affirming surgery.

Yes. Binding can change how your rib cage moves and how you breathe, especially when worn for longer periods of time. Because your breathing system, abdominal muscles, and pelvic floor work together, changes in breathing and rib cage mobility can sometimes affect pelvic floor function as well.

Physical therapy can help with rib cage mobility, breathing mechanics, muscle tension, and movement strategies to help you feel more comfortable while respecting your gender expression and goals.

Gaffing can change the pressure placed on the pelvis and surrounding tissues and may contribute to discomfort or pelvic floor symptoms for some people. Symptoms may include pelvic or genital discomfort, muscle tension, changes in bladder or bowel function, or discomfort with prolonged wear.

Pelvic floor physical therapy can help address muscle tension, mobility, pressure management, and other factors contributing to your symptoms while working with your individual needs and goals.

Yes. Pelvic floor physical therapy can provide support both before and after gender-affirming surgery. Before surgery, care may focus on pelvic floor function, breathing, mobility, strength, and preparing for recovery.

After surgery and once medically appropriate, physical therapy can help address mobility, scar and tissue restrictions, pelvic floor function, pain, and a gradual return to everyday activities and exercise, depending on your procedure and goals.

No. An internal pelvic floor exam is never required. There are many ways we can assess and treat pelvic floor symptoms without an internal examination.

If an internal assessment could provide useful information, we’ll explain why it may be helpful, what it involves, and what other options are available. You decide what feels right for you, and consent is ongoing throughout your care.

That’s okay—you don’t need to know exactly what’s causing your symptoms before you come in. Pelvic floor symptoms can overlap with issues involving the hips, spine, abdominal wall, breathing, bladder, bowel, and other areas of the body.

We’ll look at the whole picture to help determine what may be contributing and whether pelvic floor physical therapy is appropriate for you.