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A Closer Look at Gender and Pelvic Floor Physical Therapy

 We explore the barriers to pelvic floor physical therapy — especially those related to gender.
We explore the barriers to pelvic floor physical therapy — especially those related to gender.

Pelvic floor physical therapy can be a great way to treat a range of pelvic health concerns. But for folks who are part of the trans and gender nonconforming communities, taking care of pelvic health means navigating a healthcare space that wasn’t built with their needs in mind.

In this episode, Embodied returns to the topic of the pelvic floor for a closer look at the barriers trans and gender nonconforming people experience when it comes to accessing pelvic floor PT. Host Anita Rao speaks with Alex Papale, a nonbinary physical therapist and sex educator who specializes in pelvic PT for the queer and kink communities. She then speaks with Dr. Uchenna “UC” Ossai, a doctor of physical therapy and sexuality counselor with thoughts on how patients can advocate for their needs – and their pleasure – in healthcare spaces.

Also joining the conversation is Markus Harwood-Jones, an author and academic in Toronto who posts to TikTok under the handle @MarkusBones. Markus shares his experience of undergoing pelvic floor PT as a trans man and offers tips to providers for making their practices more trans inclusive.

Thank you to Keeli Gailes, Ginger Garner, Dr. Blair Peters and Nicole Guappone for contributing voice memos to this episode. And special thanks to Keeli Gailes and Ginger Garner of Garner Pelvic Health for pitching this topic and their work to put this episode together.

Three Ways to get the Most Out of Pelvic PT

1. Vet your providers in advance.

If you already work with a healthcare provider you trust, consider asking them to reach out to potential physical therapists on your behalf. Another option would be to call a prospective provider’s office yourself to assess their level of comfort and expertise when it comes to your specific concerns.

2. Explore options for affordable care.

Pelvic floor PT is often expensive and not always covered by insurance. If affording care is a concern, reach out to your provider to see if it might be possible to pay on a sliding scale, start a payment plan or opt for telehealth visits. Some physical therapists may also be willing to meet less frequently while giving you exercises to complete at home!

3. Talk about sex.

The prospect of talking about sex in a healthcare space can be intimidating, but you have every right to bring up your sex life at pelvic PT. Your provider may have thoughts on toys, tools or modifications that can support you in enjoying sex that’s pain free.

Copyright 2022 North Carolina Public Radio. To see more, visit North Carolina Public Radio.

Audrey Smith
Anita Rao is the host and creator of "Embodied," a live, weekly radio show and seasonal podcast about sex, relationships & health. She's also the managing editor of WUNC's on-demand content. She has traveled the country recording interviews for the Peabody Award-winning StoryCorps production department, founded and launched a podcast about millennial feminism in the South, and served as the managing editor and regular host of "The State of Things," North Carolina Public Radio's flagship daily, live talk show. Anita was born in a small coal-mining town in Northeast England but spent most of her life growing up in Iowa and has a fond affection for the Midwest.