The Importance of Pelvic Health Physical Therapy Following Gender Confirmation Surgery. / by Dr. Natalia P Zhikhareva


If gender confirmation surgery is a part of your gender transition, it is often a big step in one’s life.  Medical providers often spend a lot of time discussing surgery, preparation for surgery, and surgical complications that may arise during the surgery.  Apart from talking about the importance and need for post-surgery recovery, rarely do medical doctors discuss obstacles that can arise after the surgery that may limit the healing process. 

Many of these obstacles are linked to pelvic floor muscle dysfunction as the muscles and tissues heal from surgery.  Transgender-identified patients who have undergone gender confirmation surgery, will require services of a therapist specializing in pelvic health and orthopedic physical therapy.  Analogous to physical rehabilitation therapy following orthopedic surgery, it is equally important to undergo pelvic physical therapy after gender confirmation surgery.

Some of the issues arising after gender confirmation surgery may include:

  • Pelvic pain

  • Urinary incontinence

  • Difficulty using/progressing dilators

  • Voiding dysfunction

  • Dyspareunia (pain with intercourse)

  • Recurrent urinary tract infections

  • Decreased sexual response

Pelvic physical therapy helps restore the muscle and tissue integrity to enhance the recovery process.  

Post-operative pelvic health and orthopedic physical therapy may include:

  • Dilation

  • Internal and external anorectal release

  • Internal and external vaginal release

  • Connective tissue manipulation

  • Lymph drainage

  • Scar tissue mobilization

  • Myofascial release and balance

  • Visceral manipulation

  • Trigger point release

  • Muscle timing

  • Strain counter strain/positional release 

  • Lumbar/pelvic/hip stabilization and control

  • Pelvic floor strengthening/lengthening/coordination

If you are planning, or have undergone gender confirmation surgery, I cannot stress enough how important it is to undergo pelvic health and orthopedic physical therapy.  If you are local to California, I highly recommend:

To locate a pelvic health therapist elsewhere visit: Women’s Health PT Locator

Call Dr Z 310-946-6361 to book a complimentary face to face consultation.