Bottom Surgery & Physiotherapy

Supporting Transmasculine and Transfeminine Clients Through Bottom Surgery: The Role of Physiotherapy
Bottom surgery is a powerful and deeply affirming step for many both transmasculine and transfeminine individuals. Whether someone is preparing for vaginoplasty, vulvoplasty or phalloplasty, the journey is not just surgical—it’s physical, emotional, and functional. Physiotherapy can play a key role in optimising outcomes and supporting a safe, confident return to daily life.
At our clinic, we work closely with clients before and after gender-affirming surgeries to ensure their pelvic and overall health is considered throughout their surgical journey.
Pre-Surgery Preparation: Laying the Foundation
Before surgery, our physiotherapy sessions focus on building a strong foundation. This includes:
Understanding Your Body’s Baseline
We begin by gaining a thorough understanding of your current:
- Bladder and bowel function – Are there any concerns with urgency, leakage, constipation, or straining?
- Pelvic floor tone and coordination – We assess whether your muscles are overactive, weak, or uncoordinated, which can impact recovery.
- Intimate or sexual function – If relevant and comfortable for the client, we explore areas of sensitivity, pain, or tension that may influence post-op outcomes.
These baseline assessments guide us in creating a tailored prehabilitation program that optimises your function and supports a smoother recovery.
Optimising Pelvic Health
Pelvic health plays a crucial role in:
- Managing urination and bowel habits post-surgery
- Supporting circulation and tissue healing
- Reducing pelvic pain or tightness
- Preparing muscles for dilation (if applicable)
We also look at core strength, breathing, posture, and general mobility—especially important for improving blood flow, wound healing, and reducing post-op complications.
Post-Surgery Recovery: Gentle, Guided Support
After surgery, our work shifts to supporting your healing and helping you return to your life with comfort and confidence.
Wound Care & Scar Management
We guide you through:
- Gentle scar tissue mobilisations (when appropriate)
- Promoting circulation to reduce swelling
- Supporting healing around graft or donor sites (e.g., arm, thigh)
Dilation & Tissue Care
For clients undergoing phalloplasty or metoidioplasty involving a urethral lengthening or neo-vaginal closure, pelvic physiotherapy may include:
- Education around dilation (where applicable)
- Pain management strategies
- Breathwork and relaxation techniques to reduce muscle tension
Returning to Life and Movement
We support:
- Safe return to walking, lifting, cycling, gym or sports
- Managing fatigue and pacing during recovery
- Addressing any bladder, bowel or sexual function changes
We also hold space for the emotional aspects of recovery. This is a major life transition, and our approach is compassionate, gender-affirming, and always client-led.
We Are With You All the Way
Our goal is to make your body feel more like home. Whether you're months away from surgery or already on the other side, we’re here to walk beside you with skilled hands, open minds, and affirming care.
If you’re considering bottom surgery or in the recovery phase, get in touch to see how pelvic physiotherapy can support your goals and wellbeing.
More from the blog



