Support Through the Ebb and Flow of the Childbearing Year
Of course I am happy to see anyone who's having issues with their pelvic floor, and as a midwife am very familiar with prenatal and postpartum issues. But I do want to explicitly state my dedication to offering this work to trans folks of any gender, any birth assignment, and with any medical history.
Obviously trans folks can have a complicated relationship with their pelvic region, which can lead to holding stress in the pelvic floor as well as discouraging people from seeking care when there is a problem. Fear of being misgendered by a provider or hearing triggering anatomy words can be a major deterrent from getting the care you need, so I want you to know that I value your safety and your comfort. We would always progress as slowly as you need, and use your preferred words for your own body. You may always have a companion or support person with you, and we have sessions in your own home or other safe, accessible, and trans-friendly space. If you think internal work would trigger too much dysphoria, or even if you just don't want to, keep in mind there is a lot of work that we can do externally, and we can access the deeper muscles via any canals you have that you do feel comfortable using. We will only ever do work that you fully consent to. If there's anything else I can do to make you feel more seen or more comfortable, please ask.
As far as I know, I'm the only trans provider in the Portland area offering this type of care, and one of very few invested in learning more about how trans issues intersect with pelvic floor issues. In fact, the majority of local pelvic floor providers all learned from one training model which is entirely geared toward cis women, has a lot of problematic "uterus=femininity" type language, and doesn't teach anatomy or treatments for AMAB people at all. My ongoing training includes issues common to AMAB folks as well as AFAB folks, and techniques for folks with any anatomy configuation or surgical history. This was a crucial component in choosing my training, and will be as I continue to learn more.
There isn't much research out there about how bottom surgeries affect the pelvic floor, but I have talked with local surgeons about how they do their procedures and what muscles they change. We can assume that with any surgery there will be scar tissue, which can pull on fascia throughout the pelvis and create or compound any issues. Part of my training is in releasing fascial adhesions and softening scars, which would allow your muscles and organs to move more freely.
I'm currently offering discounted rates for trans people, including nonbinary folks, regardless of whether you've had or want bottom surgery. Help me get the word out!