Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management

healthtransgenderwomenkapak

PELVIC FLOOR HEALTH IN TRANSGENDER WOMEN

Fatma Zehra Kurnuç

Siirt University, Faculty of Medicine, Department of Gynecology and Obstetrics, Siirt, Türkiye

Kurnuç FZ. Pelvic Floor Health in Transgender Women. Balsak D, Aksin Ş, eds. Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.227-235.

ABSTRACT

The pelvic floor is a muscular structure organised to support the organs in the abdomen and to provide urethral, anal and vaginal continence. This muscle layer forming the pelvic floor is called m. levator ani and consists of pubococcygeus, puborectalis and iliococcygeus muscles. Concern over pelvic floor health is growing as a result of the rise in male-to-female vaginoplasty procedures.All types of male-to-female vaginoplasty, regardless of the exact surgical method employed, entail the creation of a neovaginal cavity through the dissection of the prostate, urethra, and tissues between the anterior of the bladder and the posterior of the rectum. In order to prevent complications like pain, pelvic organ prolapse, and symptoms pertaining to bladder, bowel, and sexual function, including pelvic floor dysfunction, a thorough physical examination of the patient’s anatomy is necessary. Significant anatomical features define the complex anatomical region that is the pelvic floor. Preoperative evaluation is essential regardless of the underlying cause of the high prevalence of pelvic floor dysfunction because, if dysfunction is not treated before surgery, male-to-female vaginoplasty and the formation of a neovaginal cavity may worsen symptoms. Even before surgery, patients with genetic dysphoria frequently have pelvic floor dysfunction. Preoperative evaluation of pelvic floor dysfunction is essential to enhance surgical results, even though the mechanism underlying this increased incidence is still unclear. Physical therapy has been demonstrated to significantly reduce pelvic floor dysfunction symptoms in patients before and after surgery.

Keywords: Pelvic floor; Vaginoplasty; Sex reassignment surgery; Pelvic floor disorders; Neovaginal canal

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