PHYSIOTHERAPEUTIC CARE FOR TRANSGENDER WOMEN

CLINICAL PRACTICE REFLECTIONS FROM A CASE REPORT

Abstract

Understanding the diversity of experiences related to sexuality requires recognizing the multiple gender identities that play a central role in the lived experience of sexuality. This article presents the case of a transgender woman who underwent gender-affirming surgery, emphasizing her perceptions and discussing the role of physical therapy in her recovery. The follow-up took place in a public hospital in the state of São Paulo. The surgical technique included penectomy, bilateral orchiectomy, and construction of the neovagina through penile inversion. Tissue necrosis and vaginal stenosis were complications that required additional surgical interventions. Physical therapy was provided over nine months, and the interventions included lymphatic drainage of the neovulva, use of vaginal dilators, massage, exercises for the pelvic floor muscles, and guidance for daily activities. At the end of the follow-up, a semi-structured interview identified gender dysphoria as the main reason for the surgery and indicated that, despite the complications, the patient achieved satisfaction with the outcome. This case allowed the physical therapy team to understand the feelings, emotions, and meanings that the surgical process elicited for this woman. The experience also highlighted the need to align expectations between professionals and the patient, as well as the essential role of inclusive and person-centered communication.