Gender affirmation surgery is often critical for trans people to alleviate gender dysphoria and live in a body that truly matches their inner self. It’s also a major surgical procedure that significantly changes the anatomy of the pelvic region and can cause a range of side effects. Some pain and discomfort is normal during recovery from gender reassignment surgery, but some patients have additional issues that impede the normal healing process and may cause pain to linger or even worsen over time. We at Pelvic Rehabilitation Medicine are absolutely committed to ensuring a reassuring and comfortable environment for all of our patients to find the best combination of treatment options to resolve pain and dysfunction and feel happy and at home in their bodies.
Typically patients are cleared to resume normal activity by their surgeon after about two months, but there isn’t any catch-all answer. Each patient and surgery is different, and everyone heals at their own pace. Communication and dialogue are key – if you are experiencing worsening or debilitating pain, you should report it to your physician.
Surgery or other trauma to the pelvis can cause the abdominal and pelvic floor muscles to go into a “chronic guarding state” in which the muscles shorten, becoming spastic and weak. This can result in pain from irritation of the pelvic nerves. Surgery can also leave behind scar tissue and pelvic adhesions which affect blood flow and can contribute to nerve pain.
Broadly speaking, you are more likely to experience pain symptoms following surgery if you have suffered from pelvic pain issues in the past. There are a number of pre-existing chronic pain conditions that can overlap and cause additional problems following surgery. Some of the most common include:
Underlying gynecological disorders can also make post-operative pain more likely in trans patients who were assigned female at birth. These include:
The muscles and nerves are the same regardless of which gender you were assigned at birth, which means that muscle and nerve dysfunction is broadly the same across the spectrum. However, patients who were assigned female at birth are at a higher risk of underlying gynecological disorders like endometriosis, which can increase the likelihood of pelvic pain.
We emphasize a non-operative approach to rehabilitating the pelvic muscles and nerves. This can include:
Pelvic pain issues are very frequently a sensitive and difficult issue to talk about, and this can be doubly true for transgender patients. We put our patients first and are committed to creating a judgment-free environment where everyone who comes to us feels safe and understood. If you are struggling with chronic pelvic pain, no matter who you are, we want you to know that help is available.