Transgender, Intersex, Non-binary and Gender Expansive Physical Therapy: Part 1
by Sam Arrow, PT, DPT
What is Gender Expansive Physical Therapy?
Physical Therapy is for everyone, and gender expansive folx — people who are transgender, intersex, and/or non-binary — can benefit from a more specialized approach to PT. Gender Expansive PT aims to improve gender expansive persons’ range of motion, strength, flexibility and function as they relate to their transitions. With the help of a physical therapist skilled in gender expansive person’s needs, you can pursue a treatment plan to support your body and your identity. To read more about Arrow PT’s experience with gender expansive folx, please see About page, or schedule a free consultation.
Physical therapy can be for any body part, including the pelvic and abdominal regions and this special type of PT is called pelvic floor or pelvic health physical therapy. Pelvic floor PT can treat many issues that you wouldn’t think a PT could treat, including incontinence, difficulty urinating, constipation, pelvic pain, pregnancy related issues, pelvic organ prolapse, preparing for or recovering from gender affirming surgeries, and more.
How can it help?
Folx usually seek physical therapy when they are having pain, can’t do things they used to do or are pre/post surgery. Your PT will figure out what is causing your issues and what your goals are by asking you questions and doing some tests (like checking your strength or range of motion). By the end of your appointment, your PT will talk about what they think is happening and what they can do to help.
Physical therapy can improve range of motion of joints, pain, strength, scar tissue and your ability to do the things you enjoy. Pelvic floor PT does the same thing for the pelvic and abdominal regions. Some things a pelvic floor PT might check are your ability contract the pelvic floor, also known as a “Kegel”, lengthen the pelvic floor, and make sure your muscles are working well when you cough or sneeze. They also may check your hips, back and abdomen. Your PT should look at the area that is bothering you and the areas nearby because everything is connected.
Let’s look at a person who is planning to have gender affirming masculinizing chest surgery. A PT can provide “pre-hab” or help you get ready for surgery so that recovery is as smooth as can be. The stronger and healthier your body is prior to surgery, the easier your recovery will be. This might include addressing shoulder mobility, pain, posture, trunk strength, breathing patterns or modify a work space for after surgery. PT after surgery may help with scar tissue, strengthening, posture, back and neck pain and shoulder issues once the surgeon has given the okay. A PT that treats gender expansive folx will be familiar with gender affirming surgeries and how to help you recover.
A pelvic floor PT will do the same thing for a person who is considering gender affirming bottom surgery, such as a vaginoplasty. An appointment before surgery is a very good idea because making sure your pelvic floor is functioning well before surgery is easier than trying to recover from surgery with a pelvic floor that has some issues. A PT can also help you with dilation, ways to promote healing, constipation, difficulty urinating and anything else that might come up after surgery. The same thing can be done to get ready or heal from other surgeries such as chest augmentation, metoidioplasty and phalloplasty.
What you should expect from a gender affirming physical therapist
A PT who treats Transgender, Intersex, Non-binary and Gender Expansive folx should make you feel seen in your identity, respect your privacy and adjust your exam and treatment for your comfort. This might mean using a private room, explaining how the appointment will go, asking for consent, and not making assumptions about your relationships or your identity.
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