Alyssa Hariprashad
Gender Affirmation For The Win
Take Home Messages and Nuggets
- Learn the definition of gender affirmation
- Types of gender affirming surgical options
- Gender affirming techniques
- How PT can help
What is gender affirmation?
Gender affirmation refers to an interpersonal, interactive process whereby a person receives social recognition and support for their gender identity and expression. Gender affirming surgeries have become more prevalent in order for a transgender or gender diverse individual to have their physical body align with their gender identity. For most, these surgeries are needed for their overall well-being. There are different types of surgical options that will be discussed as well as reasons as to why physical therapy can play a role in a patient’s care post-surgery.
What are some types of surgical options?
Female to Male
- Chest reconstruction
- Hysterectomy with or without oophorectomy: removal or the uterus with or without removal of the ovaries
- Metoidioplasty: utilization of existing genital tissue in order to create a new penis by using a hormonally enlarged clitoris
- Phalloplasty: surgical creation of a penis
- Difference between metoidioplasty vs phalloplasty: patients are more likely to have penetrative sex with their partner with a phalloplasty due to the penile structure being much larger than in a metoidioplasty
Male to Female
- Breast augmentation: surgery to increase breast size
- Vaginoplasty: plastic surgery performed to create or repair a vagina.
Any techniques to help these surgeries? Here are 3 important ones to consider:
- Tucking: a technique transwomen may perform to hide external genitalia and provide a smoother appearance. This involves tucking the testicles and penis between the butt or by using tight fitting underwear (a gaffe or adhesive tape)
- Binding: transmen might bind the breast tissue down in order to create a flatter appearance prior to chest reconstruction or binding can be done indefinitely without surgery. Binding incorrectly can cause many impairments and it is important to seek out help regarding posture!
- Packing: to create the appearance of a bulge in the genital region, transmen may perform packing with the use of a prosthetic. Packing may be used prior to metoidioplasty or phalloplasty OR it can be done without the end goal of surgery at all! There are many different ways to pack and there are even prosthetics to help one do so.
How can PT be beneficial?
No matter what surgery is chosen, or even if no surgery is chosen at all physical therapy can play a vital part of recovery. A physical therapist can implement a plan that can not only help an individual heal faster, but they can also do the following:
- Improve flexibility
- Improve range of motion in any area that is lacking mobility
- Manage pain levels post-surgery without always relying on medication
- Minimize scar tissue development
For example, if someone is undergoing a breast augmentation to increase hteir breast size, what happens when they magically wake up with bigger boobs? Their bodies will go through a dramatic change of weight gain that can ultimately effect their posture. A physical therapist can help with postural re-education and prevent any injuries from occurring.
Pre-hab is also an important concept to consider. Pre-rehabilitation is when one sees a physical therapist BEFORE their surgery in order to prevent any further injury. Therapy before surgery can include realignment of muscle tissue, decreasing any spasms or trigger points in muscles and increasing mobility in joints.
Phew, that may be a lot of new info for some of you but you learn something new everyday right? I will be posting more on gender affirming surgeries because there is so much knowledge that needs to be dropped!
Signing off until next time. With love always,
