Guest Post: Transgender Health and Pelvic Wellness by Debbie Cohen
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I met Debbie Cohen, PT, MS, CSCS, COMT, WCS of Fundamental Physical Therapy & Pelvic Wellness, Inc. when she was looking for a new office space.
Although she was looking for a larger space than I had to offer, I was impressed by her knowledge of the human body, her dedication to her field, and her willingness to learn how to best support transgender clients.
I asked her to create a blog post because she has services to help trans clients in ways that I cannot, through physical therapy. Please contact her if you have any questions about her skillset or her services. She can be reached at (858) 746-9782 or online at www.pelvicwellnesspt.com .
Please read more about Debbie and her work in the paragraphs below. -- Dr. Abi Weissman
Transgender Health and Pelvic Wellness
By Debbie Cohen, PT, MS, CSCS, COMT, WCS
Debbie Cohen, PT, MS, CSCS, COMT, WCS
Around 13 years ago I was sitting in a class in my physical therapy program, and the lecturer was talking about pelvic floor dysfunction. During the 2 hours of education we received in PT school on this topic, I learned that when the muscles inside a woman’s pelvis are too weak, she might inadvertently leak urine. Also mentioned was the fact that women sometimes experience pain during sexual intercourse and that has something to do with problems in these muscles as well. This was the extent of our education for what was called “women’s health physical therapy” enough for me. I knew from that point on that once I graduated I would seek out all available continuing education in order to pursue this area of specialization. I knew immediately that this is an area of huge need and offers a special opportunity to help people in a way that is no doubt hugely neglected and can change people’s lives. And isn’t that why I wanted to be a PT in the first place?
As I went through the ranks of continuing education after PT school and obtained experience as an orthopedic and pelvic physical therapist, I learned how PT’s can help with all manner of bladder, bowel, and sexual problems including every variety of pelvic pain imaginable. I am still learning every day how widespread and undertreated pelvic floor dysfunction is. By and large, doctors don’t ask and patients don’t tell, especially when it comes to sexual function. And that’s just in the heterosexual community.
I don’t have to tell you that when you add on top of that being LGBTQ, it becomes all the more challenging to have all of your sexual health concerns addressed via the usual medical pathways.
According to a report by the LGBT civil rights organization Lambda Legal, 70% of patients who are transgender or gender-nonconforming say they've faced health care discrimination.1 Survey respondents reported regularly encountering practitioners who refused to touch them or provide needed care, blamed them for their health status, or were physically rough or abusive.
I realize and understand that when you fear disrespect of harassment by health care providers, you are likely to postpone or avoid necessary medical treatment.2 If you are experiencing bladder or bowel symptoms, have sexual concerns within your orientation, are transitioning genders and have not yet met your goals of sexual function, your issues are not just urological or gynecological. They are musculoskeletal as well, and this is where a PT comes in. A physical therapist who is well trained in assessment and treatment of pelvic floor dysfunction as well as orthopedics can be a tremendous asset to your excellent medical team. The pelvic floor is a sling of muscle in the bottom of your pelvis, governing bladder, bowel and sexual function, and also an integral part of your movement system. It is part of your core, and intimately connected to the function of your spine and hips.
How should you know whether an issue you are having is something PT can help with?
You can always call your pelvic PT and ask – no question is stupid or too small. If you want to call me, I will always do my best to answer your questions or help you find an answer.
Here are just a few examples of what I know can happen in the transgender population which may not be adequately addressed:
Bladder pain or urinary problems as a result of holding urine for a long time due to not feeling comfortable using available binary-gender public restrooms.
Pain during sexual intercourse
Low back pain persisting after genital surgery
Neck or shoulder pain after breast removal surgery
Continued painful menses in a man of transgender experience
Prostate problems in a woman of transgender experience
I want you to know that when you work with me, you will be heard and respected.
You can get the physical therapy care you need and deserve, and enjoy the best quality of life that everyone deserves, regardless of gender identity or sexual orientation. Thank you, Doctor Abi, for this opportunity to share how I might be of help to people of transgender experience.
Please contact me at (858) 746-9782 for more information about my practice and to set up an appointment!
I look forward to working with you.
Debbie Cohen, PT, MS, CSCS, COMT, WCS
Fundamental Physical Therapy & Pelvic Wellness, Inc.
15706 Pomerado Rd, Suite S210-7
San Diego, CA 92064
Ph: 858-746-9782
Fax: 858-433-5728
Sources
- When Health Care Isn't Caring. Lambda Legal. http://www.lambdalegal.org/publications/when-health-care-isnt-caring. Accessed January 30, 2017.
- Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. http://www.thetaskforce.org/static_html/downloads/reports/reports/ntds_full.pdf. Accessed January 30, 2017.
- Managing Patients Who Are Transgender, American Physical Therapy Association. http://www.apta.org/PTinMotion/2016/7/Feature/Transgender/. Accessed January 30, 2017
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This post is in no way a guarantee that Debbie Cohen's services will work for you. Rather, this is a post to showcase a Poway physical therapist who provides transgender - affirming services. Please do your own research on these services and make the decision for yourself as to whether you want to utilize her services. This post also does not indicate a therapeutic relationship with Dr. Abi Weissman. Please contact Dr. Abi Weissman at (619) 403-5578 if you are looking for psychotherapy, training, or consultation in San Diego or Poway, CA or would like Dr. Abi Weissman to help you find suggestions for psychotherapists in your neighborhood.
