My partner Kevin and I had the opportunity to attend the Philadelphia Trans Wellness Conference (PTWC) this year. If you have never been, then you need to go! This is the largest conference focused on the transgender community from multiple perspectives as diverse as the community itself: medical, legal, rights, gender identity, parenting, activism, and much more. There is something for everyone even if you do not identify as being transgender. We also took time to explore Reading Terminal Market as well as The Bike Stop.

This month I want to take a moment and share some of the gold nuggets we took away from PTWC. The conference was a bit different than last year in that there seemed to be more medical workshops than surgical. Last year it seemed as though every workshop I went to was about phalloplasty! This year was more about hormone replacement therapy in regards to when to start it and how to monitor it. I still went to some of the surgical discussions, one of which was about the masculinization of the face – quite interesting! I also got to see some friends from Chase-Brexton Health Services – Sam, Dr. Pine, and Deborah Dunn – and even went to the workshops of Dr. Pine and Deborah Dunn, very informative!

Nugget 1 – A transgender child thinks the same way as the gender they identify. Numerous studies have been done to confirm that trans boys think the same way as CIS boys and vice-versa for trans girls. This gives power to the decision to inhibit/block puberty and makes perfect sense from that perspective. The drugs are not new. Precocious puberty (early onset of puberty) is a very real condition with children as young as two years old. The medications are safe and have been around for a long time. Halting puberty allows the child can to then access HRT for their identified gender at the proper time thus making the transition much easier than if started as an adult.

Nugget 2 – I was chatting with a trans guy who was asking me about carpal tunnel syndrome that developed in both wrists after starting HRT. Light bulb lit! HRT is going to change the tendons, ligaments, muscles and even bone density but it is not going to change the actual architecture of the bone. The carpal tunnel has a feminine configuration with masculine tendons and ligaments, a bit thicker than the feminine ones. Carpal tunnel is already a tight space and is now even tighter thus causing a case of carpal tunnel syndrome in both wrists.

Nugget 3 – Binding can cause back pain and breathing issues due to the altered mechanics of the rib cage. The binder will restrict normal rib expansion which can impact breathing during exercise as well as cause thoracic spine pain or even neck and low back pain.

Nugget 4 – Ohnut! One of the challenges with a neovagina is they tend to get narrow over time, a problem I was well aware of. Another aspect that I was less aware is the depth of the neovagina which means a larger partner may be penetrating too deep which can lessen the enjoyment for both and could cause harm. Ohnut is a series of stackable rings (like Legos) to be placed around the shaft and will limit the depth of penetration. The person being penetrated can relax knowing the person doing the penetrating can’t go too far and the person doing the penetrating feels as though they are having full penetration as they snugly fit around the shaft with a soft and supple material.

Nugget 5 – Trans women can develop peyronies disease (abnormal curve to the penis) due to HRT. Most physicians are unaware that this is something a pelvic physical therapist such as myself, can treat.

Sometimes it is the simple things. What a pleasure to be able to walk into a bathroom and not have to worry if it is the right one, they are all the right one here! Gender-neutral restrooms are awesome!

I strongly encourage you to attend next year’s conference. I have been twice, and each time have learned something new. I also get to expand my collection of art from transgender artists! Like I said, there is a lot there!