Urogynecologic Care and Management for Transgender Women and Men

Transgender patients experience pelvic floor disorders including urinary incontinence, pelvic organ prolapse, bowel dysfunction, pelvic pain, and dyspareunia. Female pelvic medicine and reconstructive surgeons (urogynecologists and female urologists) are experts in pelvic floor evaluation and treatment and these specialists should be involved in the care of transgender women and men who present with these disorders. Depending on the condition, treatment can include behavioral modifications, pelvic floor physical therapy, medications, and invasive treatments such as injections, implants, and surgery. In this chapter, we review the evaluation and treatment strategies of various pelvic conditions that can affect transgender patients, whether or not they have undergone genital gender-affirming surgery.