Urinary Considerations for the Transman

Main Event Page

About This Session

Approximately 1% of the population identifies as transgender or gender non-conforming (TGNC) with increasing numbers noted in younger generations, TGNC making rising to approximately 5% in Generation Z. With this rising prevalence, the need for evidence-informed care becomes increasingly more important in order to thoroughly address the pelvic health concerns for TGNC patients. Despite the growing population, research and evidence for this group continues to be sparse and focused more on transgender women and post-operative care. This lecture seeks to explore lower urinary tract symptoms (LUTS) specifically as they relate to the under-researched trans-male population.


This session will discuss common urinary complaints and primary drivers as they relate to cisgender populations. It will further discuss masculinizing interventions available and the potential impact those may have on bladder and pelvic floor function in order to extrapolate best interventions for this group. The topics of social, hormonal, medical, and surgical transitions will be thoroughly discussed, including potential side effects and implications for pelvic floor physical therapy. We will discuss patient-preferred language, mental health, and the importance of
trauma-informed care to ensure best possible care is extended to transmen.

Learning Objectives

  1. Identify ways to create a safe space for TGNC patients including: proper name and pronoun use; visual indicators in clinic
  2. Define trauma-informed care and establish practical techniques for immediate implementation in clinical settings
  3. Discuss the transitioning process for transgender men from a social, medical, and surgical perspective
  4. Consider effects of masculinizing medical, surgical, or social transition and determine the subsequent most appropriate physical therapy intervention for the treatment of LUTS in transgender men

Level

Beginner to intermediate. This lecture will build on basic concepts of bladder retraining, hormonal effects on the pelvic floor, as well as dive into complex and less common surgeries. We will define all terms that may not be common knowledge, but encourage learners to have a foundational understanding of pelvic floor dysfunction. 

Speakers

Madeline Urban, PT, DPT, Board-Certified Women's Health Clinical Specialist (she/her/hers) 

Maddy earned her Doctor of Physical Therapy degree from Washington University in St. Louis in 2020. Following her degree, she went on to complete her Women’s Health Residency at Johns Hopkins Hospital. She has been CAPP-Certified Pelvic Health clinician since 2021 and a Board-Certified Women’s Clinical Specialist since 2022. She currently acts as Pelvic Health Service Line Lead, Clinical Specialist, and Women’s Health Residency Coordinator at the Johns Hopkins Hospital.

As a member of the LGBTQ+ community herself, Maddy is actively involved in the Johns Hopkins Center for Transgender and Gender Expansive Health. She works to advocate for and passionately provides physical therapy care to members of the transgender and gender-nonconforming community. Maddy is a current member of the Academy of Pelvic Health of the APTA and has served as a lab assistant for a variety of the Academy’s pelvic health courses. Her teaching experience extends to the Maryland Chapter of the APTA where she provides continuing education on the topic of transgender care in physical therapy clinics. She has also assisted in instructing the Women’s Health course for the George Washington University's DPT program since 2021.

Nora Arnold, PT, DPT, Board-Certified Women's Health Clinical Specialist (she/her/hers) 

Nora completed her Doctor of Physical Therapy Degree at The George Washington University in 2018. She spent three years treating pelvic floor and high-level athletes prior to transitioning to her current role as pelvic physical therapist at Johns Hopkins (JH). After earning her Board Certification in Women’s Health, Nora has been serving as the Director for the JH Women’s Health PT Residency. In these roles, Nora has taken the opportunity to work closely with the JH Center for Transgender Health in order to provide inclusive and research-based clinical care and instruction. In addition to her work at JH, Nora serves as adjunct faculty for the George Washington University’s DPT program, where she is the lead instructor for their pelvic health course.

She has previously worked as a lab assistant for the Academy of Pelvic Health course on pessary management, and she has served as an instructor for the Maryland Chapter of the APTA on the topic of transgender care in physical therapy clinics. Nora has a special interest in trauma-informed care, healthcare disparities across intersectional populations, and advocating for the LGBTQ+ population. She is currently involved in a variety of research studies, including the use of chaperones in pelvic physical therapy, quantifying access to pelvic physical therapy across the United States, and examining the effectiveness of conservative treatment of stress urinary incontinence in those with Cystic Fibrosis.

Tags

• Bathroom anxiety • Binding • Bladder dysfunction • Gender Affirming Care • Gender Affirming Surgeries • Gender Expression • Gender Identity • Gender Non-Conforming • Hormone therapy • Intersex • Lower urinary tract symptoms • Masculinizing Therapies • Non-Binary • Transgender • Transgender man • Transition • Trans-male • Transmen • Trauma-Informed Care