Krystyna HollandOwner and Physical Therapist at Inclusive Care, LLC, Staff Physical Therapist at Denver Health – part of an Integrated Pelvic Health Team and a Post-Op Vaginoplasty TeamInclusive Care, LLC, Denver Health Hospital Authority

Krystyna@InclusiveCareLLC.com

Twitter Handle@tynasaurusrex

Instagram@Krystyna.Holland

Dr. Krystyna Holland is a pelvic floor physical therapist whose journey to being a provider started as a patient. Frustrations with her own medical treatment drove her to open Inclusive Care, a physical therapy practice in Denver, Colorado. There she provides affirming care to individuals experiencing painful sex, and other pelvic floor dysfunction.

Pelvic Floor PT should be about more than decreasing pain – it should be about increasing pleasure; How to talk to patients about sex in a professional way   

What being a patient taught me about the medical system and the way that providers mess it up   

Providing affirming care – tips and trips for treating transgender, intersex and gender nonbinary clients  

Pelvic Floor PT should be about more than decreasing pain – it should be about increasing pleasure; How to talk to patients about sex in a professional way.  
Pelvic floor physical therapy often has the singular goal of decreasing pain with penetration, usually done with a specific approach of manual therapy, what people perceive to be trigger point release, and graded exposure to stimulus. For people who are having painful intercourse, their experience is made up of much more than their muscular tone – how can we bridge the gap from painfree to pleasurable professionally?  

What being a patient taught me about the medical system and the way that providers mess it up We talk about patient behaviors such as anxious tendencies and pain catastrophization like they are inherent characteristics of the individual, not as coping mechanisms shaped by life experience. How can we increase patient engagement and improve outcomes for them by understanding (and explaining to them!) their behaviors and experiences as evolutionarily beneficial protective mechanisms in overdrive? Who is to blame and what is there to do when your patient isn’t responding as you expect?   

Providing affirming care – tips and trips for treating transgender, intersex and gender nonbinary clients

There are huge healthcare discrepancies in care for members of the LGBTQIA+ community, especially the latter half – transgender, intersex, and gender non-conforming individuals. What assumptions are you (unintentionally!) bringing to the encounter, and how can you sidestep them to provide affirming care without doing harm? 

  • Pelvic Floor PT should be about more than decreasing pain – it should be about increasing pleasure; How to talk to patients about sex in a professional way – Sex is an ADL and we have nationally crappy education regarding what is “normal” and how to talk about it professionally.   
  • What being a patient taught me about the medical system and the way that providers mess it up – Providers typically got into the field to care for patients and help people. They often end up frustrated when they feel unable to assist and can’t put their finger on why. The expression of this frustration and, often, subsequent ambivalence, has long reaching impacts on the patient.   
  • Providing affirming care – tips and trips for treating transgender, intersex and gender nonbinary clients – Transgender healthcare has been shown in the research to be incredibly lacking; in providers that feel confident in providing care, in patients trusting providers to provide care, and in patients’ access to care. Normalizing and providing providers with tools to feel confident in unfamiliar encounters may be able to decrease the perpetuation of medical trauma in a population that is, statistically, already highly traumatized. 
  • People are trusting the medical system to help them and experiencing medical trauma instead. It’s happening to new moms, individuals with pelvic pain, people of color, LGBTQIA+ individuals, and other marginalized groups. We have to do what we can to stop it.
  • It’s important not to assume that just because someone is your patient that they owe you anything – access to their body, following your ideal treatment plan as prescribed without their input, or intimate details of their life. Even if you want all of those things to help them, engaging people in a way that makes them feel in control and safe will: improve their outcomes, decrease their likelihood of experiencing medical trauma, and make your job easier.
  • It’s important to trust people when they tell you about themselves – about their gender, about who and how they love, about what they need from you.