IMPACTS OF PELVIC FLOOR PHYSICAL THERAPY ON TRANSGENDER WOMEN UNDERGOING GENDER-AFFIRMING SURGERY: AN INTEGRATIVE LITERATURE REVIEW

Abstract

This article aimed to analyze the impacts of pelvic floor physical therapy on transgender women undergoing gender-affirming surgery, considering outcomes such as pelvic floor function, urinary symptoms, sexual function, and maintenance of the neovaginal canal. This is an integrative literature review structured using the PICO strategy and conducted in accordance with PRISMA guidelines, with searches performed in the PEDro, LILACS, and PubMed databases between July and September 2026. After applying eligibility criteria, seven studies published between 2018 and 2026 were selected. The results showed that pelvic floor dysfunction is frequent even in the preoperative period and that interventions such as kinesiotherapy, electrical stimulation, biofeedback, manual therapy, and vaginal dilation promoted improved muscle strength and a reduction in urinary symptoms and dyspareunia, as well as successful vaginal dilation especially when interventions were individualized and initiated early. Studies that applied physical therapy routinely and without individualization showed no significant differences compared to the control group. It is concluded that pelvic floor physical therapy plays a significant role in the functional rehabilitation of transgender women undergoing gender transition, with careful assessment and the individualization of therapeutic approaches being essential.