Gender-Affirming Care

Binding is an effective non-surgical way to affirm gender identity. While it can boost confidence and comfort, it may also come with challenges, including pain, limited range of motion, and skin issues. Additionally, binding can exacerbate certain health conditions, such as asthma, myofascial pain, and ribcage dysfunction.

Our practitioners can provide treatments to address:

• Chest and Shoulder Pain: Binding can cause nerve compression, thoracic wall changes, and altered shoulder girdle mechanics. We offer manual therapy, soft tissue release, mobility exercises, and strategies to reduce discomfort and improve muscle function.
• Pelvic Floor and Abdominal Pressure: Prolonged compression from binders can increase pressure on the pelvic floor and lower abdomen, which may contribute to incontinence and pelvic pain. We create tailored programs to decrease pain, reduce pressure, and strengthen affected areas when needed.
• Ribcage and Breathing Mechanics: Restricting ribcage movement and sustained pressure can impact breathing quality and posture. It can also affect underlying lung conditions such as asthma and COPD, limiting deep breathing. Our team integrates breathing exercises and posture work into treatment plans to support long-term health.

Preparing for gender-affirming surgery is a significant step in your journey, and the appropriate preparation can greatly impact the success of your recovery. Pre-hab strengthens and conditions your body for surgery, enhances mobility, and addresses potential risks, helping you approach surgery informed and in optimal shape. Surgical pre-hab plans are tailored to your unique needs and may include:

• Physical Conditioning: Tailored exercises to improve strength, flexibility, and endurance, helping you recover more quickly and reducing post-surgical complications. 
• Breathing and Posture Techniques: Practice pre-surgical breathing exercises and posture work ahead of time to support optimal lung function to improve your post-surgical recovery. By familiarizing yourself with these techniques before surgery, you’ll feel confident and prepared to use them effectively during recovery, reducing strain on your body throughout the healing process and getting back to your regular activities as quickly as possible 
• Pelvic Health Optimization: Addressing pelvic floor and abdominal muscle function to support better surgical outcomes and reduce the risk of post-operative complications such as incontinence or pelvic pain. This may include strategies for coordination, relaxation and mobility, depending on your individual needs.
• Scar and Tissue Health: Learn strategies to support optimal tissue healing and scar care to align tissue fibers for optimal movement, and decrease the risk of impaired function and mobility post-surgery.
• Education & Empowerment: Understanding your surgical journey is key to a smooth recovery. We provide guidance on what to expect before and after surgery, helping you make informed decisions, feel confident in your care, and actively participate in your healing process.

Recovery from gender-affirming surgeries is complex and requires specialized care. Our team has completed advanced training to provide effective support for these procedures. We can help with:

• Post-Operative Care Plans: Personalized rehabilitation to reduce pain, improve mobility, and support tissue healing.
• Scar Management: Techniques to minimize scar tissue and restore function.
• Strength and Mobility Restoration: Tailored exercises to rebuild strength, improve flexibility, and enhance overall function.
• Education & Empowerment: Healing is a journey, and we’re here to support you every step of the way. Following your surgeon’s recovery guidelines, we provide clear guidance on post-surgical care, help you understand what’s happening in your body, and equip you with the tools to actively participate in your healing. 

Breast or chest reduction & construction can lead to changes in upper body mechanics and posture, which may affect movement patterns and cause discomfort. To support upper body care either before or following surgery, we focus on:

• Restoring Upper Body Mobility: Exercises to improve shoulder function, enhance range of motion, and release tension.
• Scar Tissue Management: Scar Tissue Management: We focus on improving flexibility, circulation, and overall scar health to support your recovery. Our treatments help reduce restrictions, enhance mobility, and promote healthy tissue function. By boosting blood flow and optimizing healing, we aim to minimize discomfort and support long-term recovery.
• Postural Alignment: Techniques to address postural changes, reduce strain on the spine and muscles, and help you feel aligned and comfortable.
• Breath Mechanics: Assistance with chest expansion and deep breathing to support your recovery after binding or top surgery.
• Strengthening and Rehabilitation: Personalized therapy to rebuild strength, restore fluid movement, and support your recovery.
• Education: Understanding the ‘why’ behind your care is essential for long-term success. By educating you on how surgery impacts your body and the importance of ongoing self-care, we empower you to maintain lasting results. With the right knowledge, you can confidently navigate your recovery, ensuring you feel supported and capable throughout your journey.

Vaginoplasty is a transformative surgery that requires ongoing care to maintain the shape, size, and function of the vaginal opening and vaginal canal. Our physiotherapists provide guidance on essential practices to support healing and function. This includes regular accommodation exercises to prevent narrowing, shortening, or closure, using lubricants to maintain tissue health and comfort, and strategies to reduce the risk of urinary tract infections—particularly due to changes in the urethra. They’ll also provide advice on proper hygiene, hydration, and other key steps to minimize risks and support long-term pelvic health.

Vulvoplasty creates external genitalia without forming a vaginal opening. Proper care of the new vulva post-op is crucial for healing and preventing complications such as urinary tract infections and tissue health. Our physiotherapists provide guidance on scar tissue management to improve circulation and support healing, offer advice on maintaining the health of your external genitalia, and educate you on hygiene practices to reduce the risk of UTIs, particularly with changes to the urethra.

For many individuals, a hysterectomy can be an important part of their gender-affirming journey, providing alignment between their body and identity. However, the removal of the uterus and cervix also alters the structure and support of the pelvic area. Pelvic health physiotherapy is a valuable resource in this recovery process, focusing on strengthening the core and pelvic floor to support the bladder, intestines, and other pelvic organs.

In addition to enhancing support to the pelvic area, physiotherapy and massage therapy can help manage post-operative pain, address scar tissue, and improve core strength and posture. These efforts aim to prevent complications such as pelvic organ prolapse, incontinence, and discomfort during sexual activity, while also promoting overall pelvic health.

The removal of the uterus and ovaries, often referred to as a hysterectomy with oophorectomy, is a significant surgical procedure that brings changes to the pelvic region and overall physical and hormonal health. Pelvic health physiotherapy can be key in supporting recovery and adapting to these changes.

This procedure alters the structural support of the pelvic area, which can impact the bladder, intestines, and other surrounding organs. Treatment may focus on:

• Strengthening the Pelvic Floor: Ensuring stability and support for remaining organs.
• Scar Tissue Management: Supporting flexibility and circulation to optimize healing and tissue function. Treatment helps improve mobility, enhance blood flow, and promote overall scar health. Improved circulation ensures proper tissue function, reducing restrictions and discomfort while supporting long-term recovery.

• Improving Core Strength and Posture: Reducing strain on the pelvis and lower back.
• Addressing Medical Menopause: Removing the ovaries induces menopause, leading to hormonal changes that can affect tissue health and overall well-being. Our care focuses on managing symptoms such as genital dryness and other effects of hormonal shifts. Through targeted treatment, we support tissue function and help ease the transition your body is undergoing.

Treatment may include both physiotherapy and registered massage therapy (RMT) to help reduce the risk of complications such as abdominal and gastrointestinal issues, internal scarring, bowel and bladder concerns, pelvic organ prolapse, incontinence, and discomfort during sexual activity. If you’re unsure whether physiotherapy or RMT is the right fit for you, our team is happy to help—reach out to the clinic for guidance on the best approach for your needs.

Tucking is another non-surgical way to affirm gender identity, offering increased emotional comfort and confidence for many individuals. However, it can also create physical challenges and discomfort. Prolonged tucking can place pressure on the pelvic floor, lower abdomen, and soft tissue areas, which may lead to pain, muscle strain, and in some cases, contribute to urinary or digestive issues. Our physiotherapists can help address the following:

• Pelvic Floor Health: Tucking can impact the mechanics, structure, and function of the pelvic floor muscles and soft tissues. This can lead to discomfort, pelvic pain, or difficulty with urination or ejaculation. We provide targeted pelvic floor therapy, including gentle exercises and techniques to relieve pressure and improve comfort and function while reducing complications from tucking.
• Abdominal and Groin Strain: The sustained compression caused by tucking can cause strain on the abdominal muscles and groin area. This can lead to muscle tightness, reduced flexibility, or even injury over time. We offer manual therapy, soft tissue work, and stretching routines to alleviate tension and restore movement.
• Education: We help you understand how tucking affects your body’s mechanics and emphasize the importance of listening to your body. By offering guidance on proper techniques, we’re here to help you make informed decisions and avoid strain on your pelvic floor and abdominal muscles. Our goal is to equip you with tools to safely incorporate tucking into your routine while maintaining long-term pelvic health and comfort.

Erectile Tissue Release
Choosing an erectile tissue release as part of your gender-affirming care is a personal and meaningful decision. It involves cutting the ligaments supporting the clitoris so the head drops down and away from the body creating a penis. Whether you’re preparing for or recovering from surgery, our goal is to support you in maintaining or improving the function and health of your erectile tissue. Our physiotherapists support you through:

• Education: Practical, comprehensive education to support the care and health of your genitalia.
• Pelvic Health: Ensuring optimal pelvic health improves overall tissue health, circulation, and sexual functioning post-surgery. 
• Tissue Health: After an erectile tissue release, maintaining the health and function of the tissue is essential for optimal recovery. Our physiotherapists guide you through self-directed exercises and provide personalized education to promote blood flow, support tissue elasticity, and encourage healing. While we don’t provide hands-on treatment directly to erogenous tissues, we offer the necessary tools and strategies to help you manage scar tissue, reduce restrictions, and maintain long-term tissue health.
• Sexual Health: After an erectile tissue release, sexual function can change, and your sexual health needs may shift. We understand that these needs may be different before and after surgery, and we provide a safe, open space to discuss your goals and concerns. Our physiotherapists are experienced in supporting this transition and are here to help you navigate these changes.

Metoidioplasty is a procedure that creates a penis using existing genital tissue, often preserving sensation and erectile function. While this surgery is less extensive than a phalloplasty, recovery still requires careful attention and care. We can help with:

• Pelvic Health Optimization: Focusing on pelvic floor muscle function to enhance outcomes, reduce discomfort, and improve overall pelvic health.
• Bladder and Bowel Health: Education and strategies to manage changes in urinary or bowel function post-surgery. 
• Functional Support: Exercises to improve mobility, posture, and strength as your body adjusts post-surgery.
• Tissue Health: Post-surgical tissue care is vital for healing and maintaining mobility. We offer strategies to promote optimal tissue health through scar tissue management, stretching, and techniques to enhance circulation and reduce adhesions, helping the tissues remain flexible and functional.
• Sexual Health: Our goal is to help you feel informed and empowered in your sexual health journey. We provide education and support to help you navigate changes in sexual health post-surgery. This may include practicalities on function, managing sensation, and optimizing comfort during sexual activity.

Phalloplasty is a gender-affirming surgery that creates a penis using grafted tissue, often from the forearm, thigh, or abdomen. This life-changing procedure involves a complex recovery process that requires specialized care to restore optimal health post-operatively. Our care focuses on:

• Scar Tissue Management: Education on scar care, circulation, and overall tissue health is essential for recovery. Guided breathwork and specialized techniques help improve tissue elasticity, promote healing, and reduce restrictions both at the donor site and on the new phallus. 
• Pelvic Floor Rehabilitation: Exercises to ensure pelvic floor muscles are functioning optimally, addressing issues such as incontinence or pain that could result from surgery.
• Nerve Health and Sensation: Strategies to support nerve regeneration and improve sensation at the surgical sites.
• Functional Movement and Strengthening: Personalized plans to help you regain strength, mobility, and confidence in daily activities as a result of deconditioning in your recovery phase.
• Tissue & Muscle Health: Effective circulation and muscle function are essential for a successful recovery after phalloplasty. Our care focuses on improving blood flow to both the donor site and the newly created phallus, while also supporting pelvic floor muscle health to ensure strength, flexibility, and optimal function. Our team is knowledgeable about tissue healing and will follow your surgeon’s guidelines to ensure optimal recovery. We are here to support you with expertise and compassion.
• Sexual Health: Following phalloplasty, sexual function can change, and your sexual health goals may evolve. We provide a safe, open space to discuss these changes and address your unique needs before and after surgery.

A scrotoplasty involves creating a scrotum from the existing vulvar tissues. Individuals can opt to receive testicular implants after the newly constructed scrotum has fully healed. Testicular implants are made of medical-grade silicone and are implanted into the scrotum. Opting for a scrotoplasty with or without testicular implants can be an integral piece of your gender-affirming journey.  Areas our physiotherapists can help with:

• Post-Surgical Rehabilitation: Support for tissue healing, reducing swelling, and improving comfort.
• Scar Management: Techniques to minimize scar tissue formation and ensure healthy tissue function and mobility.
• Pelvic Floor Support: Targeted exercises to optimize pelvic floor function and alleviate post-surgical discomfort.
• Pain Relief: Targeted strategies to alleviate tenderness and support your recovery process.
• Tissue Health: Our physiotherapists provide you with personalized self-directed exercises that enhance circulation, improve tissue elasticity, and support healing. We offer the knowledge and techniques to manage scar tissue, minimize restrictions, and maintain tissue health, ensuring you achieve lasting results and optimal long-term function.
• Sexual Health: Guidance on resuming sexual activity, supporting functionality, and understanding when it’s safe to resume based on your post-surgical guidelines. We recognize that each individual’s situation is unique, and we provide tailored advice to ensure a safe and comfortable return to sexual activity, respecting the specific nuances of your recovery.

The removal of testes (orchiectomy) can be a significant step in your gender-affirming journey. While this procedure may reduce the need for long-term testosterone blockers, it can also affect pelvic health, hormone levels, and overall comfort. Our approach includes:

• Pelvic Floor Support: Exercises and techniques to strengthen the pelvic floor and address any discomfort or dysfunction that may arise post-surgery.
• Scar Tissue Management: Techniques to reduce scar tissue and improve mobility in the surgical area.
• Pain and Discomfort Relief: Targeted techniques to alleviate postoperative pain and increase comfort throughout the healing process.
• Tissue Health: Fostering optimal tissue recovery through targeted techniques to promote healing and restore functionality. This includes managing scar tissue, improving circulation, and supporting tissue elasticity to ensure long-term comfort and mobility in the affected areas. 
• Sexual Health: Practical guidance on resuming sexual activity post-surgery, with a focus on when it’s safe to begin and how to improve comfort and function based on your specific recovery needs.

Hormonal changes can impact your pelvic health, leading to issues like internal genital (vaginal) dryness. These changes can cause discomfort, and pain during sexual activity, and may affect overall pelvic floor muscle function.

• Pelvic Floor Muscle Functioning: Exercises tailored to address the impact of testosterone on the pelvic floor, helping to restore function.
• Moisture Restoration and Comfort: Strategies designed to alleviate dryness and provide relief, improving your comfort during daily activities and intimacy.
• Discomfort Management: We can suggest techniques to alleviate irritations such as burning or itching, helping you restore confidence and comfort in your body. 
• Tissue Health: Maintaining proper hydration and circulation is essential for the health of your pelvic tissues. These factors support tissue function and help alleviate dryness, improving overall comfort and reducing sensitivity. Proper tissue care promotes long-term pelvic health and supports optimal function.
• Sexual Health: Understanding the importance of tissue moisture is essential for reducing friction and ensuring comfortable penetration if that is a desired outcome for you. Internal genital dryness can negatively impact tissue health, function, and quality. Our pelvic health physiotherapists can provide practical tips to increase vaginal health promoting comfort and enhancing overall sexual health.

We recognize that the pain you experience as part of your gender-affirming journey is real and valid. Managing persistent pain can be challenging, and we’re here to help you navigate it with care and support. We offer a range of strategies to enhance your physical comfort, including:

• Manual Therapy: Targeted treatments to enhance muscle and joint mobility, alleviate tension, and reduce nerve compression.
• Exercise-Based Interventions: Customized programs to improve strength and mobility.
• Stress Reduction Techniques: Breathing exercises and mindfulness practices to help you manage pain holistically. 
• Education: We provide education on pain health and the management of persistent pain, helping you understand how to navigate and address it. With research supporting a global, holistic approach, we explore various strategies to reduce pain by identifying both local and broader contributors. Our goal is to empower you with the knowledge and tools needed to manage pain effectively and improve your overall well-being.
• Psychological Support: We understand the emotional toll that persistent pain can take. Our team of Registered Clinical Counsellors is available to help you address the psychological aspects of pain.

As you continue your journey, understanding your evolving sexual health and intimacy needs is essential. It’s important to have a safe, supportive space where you can openly discuss your experiences, explore your new anatomy, and address any concerns. At Bump, your sessions with our physiotherapists provide just that – a confidential space dedicated to your well-being. We are here to help you optimize your sexual health through:

• Safe and Compassionate Care: A non-judgmental space to openly discuss your needs and concerns related to sexual health and intimacy.
• Understanding Your New Anatomy: Guidance on how to adjust to your body and how your anatomical changes relate to sexual wellness.
• Education on Hormone Health: Understanding the impact of hormonal changes is key to navigating intimacy and pleasure. Our physiotherapists provide strategies to enhance your sexual health and intimacy. We offer education on how hormonal shifts may affect your body and provide support to help you adjust and optimize your experience of intimacy in a way that feels right for you.
• Sexual Goals: As you move forward, your sexual health goals are likely to shift and change. That’s completely natural. We’re here to help you identify these changing goals and develop practical, personalized strategies to achieve them, guiding you with sensitivity and care throughout the process.
• Product Education & Support: We can provide insight on sexual health products and resources from a physiotherapy perspective, focusing on how they can support your needs. Whether it’s finding the right tools for comfort, pleasure, or healing, we offer expert advice to help you make informed choices.

Bladder and bowel health can be affected by gender-affirming procedures, practices, and hormone therapies. Identifying and addressing the root causes of any dysfunction is crucial for effective care. Our team combines the expertise of pelvic health physiotherapists and registered massage therapists to support your recovery. Together, we work with you to improve bladder and bowel function through:

• Pelvic Floor Muscle Training: Your pelvic health physiotherapist may prescribe exercises designed to support bladder and bowel control, reduce incontinence, and improve pelvic health.
• Bladder and Bowel Function: Pelvic health physiotherapists use targeted techniques to re-establish healthy bathroom habits and alleviate discomfort, focusing on improving bladder and bowel control while addressing underlying issues to support overall well-being. They provide evidence-based education on hydration and hygiene practices to help maintain optimal bladder health. Additionally, bladder mobilization techniques performed by RMTs can enhance urinary function and overall comfort.

Additionally, our Registered Massage Therapists can assist with abdominal visceral techniques that impact bladder and bowel function, such as bladder release, constipation relief through abdominal massage, and addressing scar tissue.

Your pelvic floor plays a critical role in overall well-being. Changes due to surgery, hormone therapy, or gender-affirming practices can impact its function, potentially leading to discomfort or incontinence. Our pelvic health physiotherapists provide compassionate, targeted care to address the root of your pelvic floor dysfunction, support healing, and optimize pelvic health for long-term well-being.

• Pelvic Floor Muscle Function: Comprehensive assessment to evaluate how your pelvic floor muscles are functioning and how they may be affected by surgery, hormonal changes, or post-surgical recovery. Treatment focuses on optimizing function, improving coordination, and addressing the root cause of discomfort, if present.
• Incontinence Management: Gender-affirming surgeries, hormone therapy, or changes in pelvic health may lead to urinary or fecal incontinence, affecting daily life and well-being. Our pelvic health physiotherapists work with you to develop personalized strategies for managing incontinence.

Understanding your body and its changes is key to long-term health and well-being. Knowledge empowers you to make informed decisions and take control of your journey. At Bump, we recognize that comprehensive education plays a vital role in achieving better outcomes, which is why it is a core component of our care. Our goal is to help you navigate the physical, emotional, and psychological aspects of your gender-affirming process.

Progress doesn’t only happen during the time you spend with your practitioner; it’s in the 23 hours outside of it. Our informative sessions provide you with the tools to continue making positive strides in your daily life, even outside the treatment room. We also provide you with the information you need to feel empowered to ask questions, engage in tough conversations, and advocate for yourself. You deserve to feel in control of your care, and we’re here to ensure your voice is heard and your needs are met.

By equipping you with the knowledge and tools to understand your body’s needs, we empower you to feel confident, supported, and in control of your path forward. Our holistic approach ensures you receive well-rounded care, and for specialized support, our team includes Registered Clinical Counsellors who can offer additional guidance.