Grant: Travel Awards - Institute Community Support

Background.Transgender women may experience pelvic floor problems that affect their comfort in daily life. These problems can include urinary or fecal incontinence, pelvic pain, genital prolapse, and complications following gender-affirming surgery such as vaginoplasty. Despite these health concerns, there is very little research on how physiotherapy can help transgender women manage pelvic floor dysfunction (PFD). This lack of evidence limits the ability of health professionals to provide inclusive, evidence-based care. Purpose.This scoping review aimed to map the available research on conservative (non-surgical) physiotherapy interventions designed to improve pelvic floor health in transgender women. Methods.We followed established guidelines for scoping reviews. Six major databases were searched, and additional sources were identified through reference tracking. Two reviewers independently screened and analyzed the studies. We summarized the findings based on the type of intervention, outcomes, care setting, and type of pelvic floor dysfunction Results.Six studies met the inclusion criteria. All focused on pelvic floor rehabilitation around the time of vaginoplasty. Reported interventions included manual therapy, therapeutic exercises, vaginal dilation protocols, and education. While some benefits were observed liked reduced pelvic pain and improved comfort with dilation, interventions varied and were not standardized. No studies explored pelvic floor care outside the surgical context, such as issues related to hormone therapy or gender-affirming practices like tucking. Conclusion.This review highlights two priorities. First, standardized physiotherapy protocols are needed to support recovery after vaginoplasty. Second, research must expand to include transgender women who experience PFD in other contexts. Addressing these gaps will improve personal health outcomes, reduce complications, and help build a more inclusive and responsive health care system.