Beyond the Binary: Pelvic Pain and Pelvic Floor Disorders in Transmasculine Patients

Transmasculine and gender-nonconforming (TMGNC) people who were assigned female at birth also experience pelvic floor disorders (PFDs) and chronic pelvic pain (CPP). This group of patients interacts with the health care system uniquely and has different barriers to care compared with cisgender women.

The objectives of this study were to (1) qualitatively analyze how TMGNC individuals experience PFDs and CPP and (2) to explore participants' interaction with the health care system while obtaining PFD- and CPP-related treatment.

Candidates were identified by chart review. Semistructured, in-depth, one-on-one interviews were conducted using a standardized interview guide. The presentation, perception, and experiences of pelvic floor symptoms and interaction with the health care system of TMGNC persons were explored. Interviews were audio-recorded and transcribed. The transcripts were coded using MAXQDA software. Emergent themes were identified by debriefing with the researchers. Codes for themes and subthemes were then developed, and the transcripts were reanalyzed.

Fourteen participants were interviewed. Themes were organized into the following: symptom distribution, symptom management, impact on daily life, interactions with the medical system, and access to trans-friendly care. Participants experienced overactive bladder symptoms, urinary incontinence, vaginal dryness, and pain after orgasm. They often altered their lifestyle to deal with symptoms. All participants had both positive and negative interactions with the health care system.

This study helps elucidate symptoms experienced by TMGNC patients. Using this qualitative data, potential health care system barriers may be identified and mitigated to improve quality of care for this population. Additional research is needed to fully characterize the unique needs of TMGNC individuals.