Gender Affirming Surgery
Some transgender and gender diverse people seek gender affirming care (GAC) to help affirm their gender. This care comes in many forms. For example, it may include non-medical practices or hormone therapy. Or it may consist of surgical procedures that impact various areas of the body.
Pelvic Surgery or genital reconstruction procedures (often called Bottom Surgery) can be performed for either feminising GAC or masculising GAC. The specific surgeries a person pursues vary greatly based on individual goals, medical considerations and access to care. Of course, not all transgender people choose to have surgery. However, if you do, Pelvic Health Physiotherapy can help with both bottom and top surgery preparation and your recovery.
Expert advice that makes all the difference.
If there’s one thing for sure, having gender affirming surgery is easier with a team you can trust and who can give you the expert advice you need. Our postgraduate-qualified pelvic health physiotherapists can help you prepare for and recover from your specific gender affirming surgery. We’ll identify and address issues around bladder, bowel and sexual function and pelvic floor muscles. And we’ll also give you advice on useful things like lifting and general exercise. Together with your medical and surgical team, we’ll make sure you feel supported and at ease before and after your surgery, so you can get on with living life the way you want to.
Not all transgender people choose to have surgery. However, if you do, Pelvic Health Physiotherapy can help with both Bottom and Top Surgery preparation - and your recovery.
The most common types of gender affirming surgeries
For transgender women and transfeminine individuals:
- Vaginoplasty and Vulvoplasty - Involves removing the penis (penectomy) and creating a vulva with or without a functional vaginal canal. This is one of the most common Bottom Surgeries.
- Orchiectomy – Removing the testicles, which can be done alone or as part of Vaginoplasty
- Breast Augmentation – Placing Breast Implants to increase breast size when hormone therapy hasn't achieved the desired results
- Facial Feminisation Surgery (FFS) - Various procedures to create more feminine facial features, including work on the brow, nose, jaw and Adam's Apple (Tracheal Shave)
For transgender men and transmasculine individuals:
- Top Surgery (Chest Masculinisation) - Removing breast tissue and reconstructing a more masculine chest contour. This is often the first and sometimes only surgery pursued.
- Hysterectomy, Oophorectomy and Vaginectomy: Where the vaginal canal, uterus, and/or one or both of the ovaries are removed
- Phalloplasty: Involves creating a penis using a tissue flap from the groin, outer thigh or forearm
- Metoidioplasty: Involves releasing erectile tissue (clitoris) from restraining structures, allowing it to move into a more forward and elevated position. This may also involve a urethral lengthening procedure to allow standing urination.
- Other procedures - Including voice surgery, body contouring procedures and various other feminising or masculinising surgeries
Our Proven Pathway for Supporting Gender Affirming Surgery
Discover what matters
You’re assessed as a whole person
We begin by learning all about you as a whole person, not just a patient. So, your postgraduate-qualified pelvic health physiotherapist will gather the following info:
- QUESTIONNAIRE: You’ll complete a pelvic health questionnaire online before your first visit. This helps us understand your history, health concerns and what matters to you.
- 1-on-1 CONSULTATION: Here, we’ll learn about you and your upcoming or recent surgery. We’ll also discuss your current bladder, bowel and sexual function. We believe a holistic approach helps us to understand how your specific physical, emotional and lifestyle factors influence your pelvic health.
- THOROUGH ASSESSMENT: This may include an abdominal and pelvic floor examination, bladder diary, bowel diary and questionnaires to understand your thoughts, feelings and environment.
- CONNECTING THE DOTS: Now that we’ve discovered so much about you and your pelvic health, we can explore how it all fits together with your surgery prep and recovery. For example, if you have constipation issues, we can ensure this doesn’t negatively impact your recovery. Or maybe we’ll need to discuss the importance of a strong pelvic floor, which will help you after surgery, as well as prevent other problems.
- SET GOALS: We’ll help you set meaningful pelvic health goals, such as:
- Know that I’m doing everything I can to get the best surgical outcome
- Recover quickly from my surgery
- Prevent any new bladder or bowel problems
- Feel confident to return to exercise
- Be open to exploring an intimate relationship
Restore what matters
You’ll have a personalised pelvic health plan.
This second step is all about taking action. Together, we’ll choose the most suitable, evidence-based treatment options to fit your lifestyle. You’ll learn what to expect from surgery, any recommended lifestyle adjustments during recovery, and how to safely return to your usual activities.
Whether you’re seeing us before or after your surgery, we’ll create a personalised pelvic floor and abdominal muscle program to help these vital muscles work at their best. This might involve building strength, improving endurance or relaxation or simply building an awareness of your muscles as they will feel, and need to function, differently.
If you’re having a vaginoplasty, we’ll guide you through what to expect with dilator therapy, optimal positions, breathing techniques and pelvic floor relaxation. We’ll also address any difficulties with pain, muscle tension or anxiety during dilation with desensitisation techniques and nervous system strategies such as guided relaxation and breathing.
We’ll work with you to plan a gradual return to the activities and exercise you enjoy. And if any bladder, bowel or intimacy concerns arise, we’re here to help with those too, every step of the way. If you experience any pelvic pain, we can help you address it and give you useful resources and tools to help you progress. You’ll have all your bases covered!
ABOUT YOUR APPOINTMENTS: Together, we’ll work out how often we should see each other. We’ll agree on what works best for you, your commitments and your finances.
Enjoy what matters
You’ll be living your best life.
The third step is about ensuring you achieve all the meaningful goals you set at the start. Once you’ve recovered from your surgery, you might even find you can embrace new possibilities that you hadn’t considered before. Perhaps you’ll discover a new sport or social group. Or maybe you’ll feel that you’re now open to exploring intimacy. You’ll be equipped with good bladder and bowel habits and have the confidence in your body to take on whatever you choose.
Sometimes, though, life’s twists and turns might mean you need to visit us again for a reset. Perhaps you might experience a stressful life event, get a nasty virus, or develop bladder issues. Whatever the reason, at Pelvic Health Matters, we’ll always be here to help you.
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Pelvic Health Matters
New name.
Same exceptional care.
Formerly known as Women’s & Men’s Health Physiotherapy, our new name reflects both what we believe in and what we do. We have an unwavering belief that pelvic health matters for everyone, at every stage of life.
Same phone number: 03 8823 8300
New email: physio@pelvichealth.com.au