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We Provide Transgender Care

What kind of transgender care does the Urogynecology Wellness Clinic provide?
 

Pre- and postoperative care:

We provide pre- and postoperative care for transgender and nonbinary patients undergoing
reconstructive “bottom” surgeries such as vaginoplasty, phalloplasty, and metoidioplasty. 
Many transgender Albertans travel long distances to access bottom surgery. Providing gender-affirming perioperative care closer to home helps our patients achieve their goals safely and with appropriate support. Care includes:
- Preoperative appointments to help patients prepare for bottom surgery
- Postoperative follow-up appointments to evaluate healing, address complications, and
support recovery
- Pelvic floor physiotherapy to help with postoperative dilation

Gender-affirming urogynecological health care:

We also provide gender-affirming pelvic health care for transgender and nonbinary patients who were assigned female at birth and have not had reconstructive bottom surgery. Care includes:


o Pelvic organ prolapse assessment and care
o Treatment for chronic urinary tract infections
o Treatment for urinary incontinence

Why is the transgender care clinic housed at the Lois Hole Hospital for Women?


The transgender care clinic is housed at the Lois Hole Hospital for Women to give patients
access to a multidisciplinary care team that includes urogynecologists, pelvic floor
physiotherapists, and specialized continence nurses. We recognize that some transgender patients may feel unsure or uncomfortable accessing care through a women’s hospital. We have worked hard to create a supportive clinic environment within the Lois Hole Hospital where transgender patients’ names, pronouns, gender identities, and gender expressions will be respected and welcomed. Our team members take an active interest in transgender health and are committed to providing appropriate and gender-affirming pelvic health care for all patients.

External resources (Click The Underlined Links for More Information)


- Alberta Health Services: Alberta’s Gender Reaffirming Program
o FAQ about the gender-affirming surgery approvals process in Alberta
- Trans Wellness Initiative: Surgery navigation in Alberta
o Outlines the criteria and the approvals process for accessing feminizing and
masculinizing gender confirmation surgeries in Alberta

- Rainbow Health Ontario: Surgical summary sheets
o Outlines techniques, results, risks, and perioperative care
recommendations for common transition-related surgeries

- Procedures performed at GrS Montreal:

Masculinizing genital surgeries , i.e. metoidioplasty, phalloplasty
Feminizing genital surgeries , i.e. vaginoplasty

Political Statements on Gender Affirming Care:

Alberta Medical Association: Statement from the AMA Section of Child and Adolescent Psychiatry on gender-affirming treatments

Alberta College of Family Physicians: Statement from the ACFP on Gender-Affirming Care in Youth

Alberta New Democratic Party: Empowering Truth: Experts and Allies Debunk Danielle Smith's Anti-Trans Policy

Canadian Medical Association: CMA strongly opposes government efforts to restrict access to care

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International Projects

Peru:

Over several years starting in 2015, Dr. Flood and Dr.Poirier along with multiple health professionals including Chris and Sarah (physiotherapy) and Donna (nurse continence advisor) partnered with the NGO Sombrilla, traveled to Peru as an attempt to enhance education and training in the conservative management of pelvic floor disorders. The project extended over four years of working with Peruvian healthcare professionals to provide training in holistic treatment of pelvic floor disorders. We introduced and promoted the use of pessaries and pelvic floor physiotherapy and to facilitated it’s uptake throughout the country with a focus on accessibility for poor and indigenous women. We worked within the Peruvian healthcare system at various levels supporting access to training for healthcare professionals and supporting them in requesting access to pelvic floor physiotherapy and pessaries (medical implements used in pelvic floor care) in the country. A priority was to work in communities of poor and indigenous women who have the least health care access in the country. Indigenous and local women were trained to build awareness of pelvic floor health in their communities promote prevention and connect women with local care providers.
Our connections with the many health care professionals in Peru involved:
- meetings and educational sessions with universities including Universidad Nacional Mayor de San Marcos
- promotion of the training of a urogynecologist in Peru
- supporting Francisca Robinson, the leader in pelvic floor conservative management in Peru
- provided clinics in multiple health centres in Huarez, Lima and Cajamarca
- provided workshops and lectures to healthcare workers and faculty in Huarez, Cajamarca and Lima
- educational sessions and meetings with faculty in Peru, using the introductions by Dr Jorge Mayo
- presentations at the Urogynecology Society in Lima
- presentations at the Peruvian Society of OBGYN annual meeting
- presentations at the ALAPP (Asociacion Latinoamericana de Piso Pevico) in Mexico City
 

Currently with Covid 19, our travel is limited however we are hoping to continue to forge relationships with the country’s urogynecology development.

Nepal:

Nepalese women have the highest reported incidence of genital prolapse in the world. Because of this, the Nepal government has partnered with FIUGA (Foundation for International Urogynecology Assistance) and has developed a fellowship in Urogynecology. Dr Mohan
Chandra Regmi is the fellowship director. The curriculum hosts international surgical faculty and a remote lecture series.
Dr. Flood was accepted to travel to Nepal as international surgical faculty in 2020, however this is now on hold given the world, and Nepal’s, struggles with the pandemic. We are hoping that this program will resume in the future. In the meantime, our faculty contribute to the remote lecture series, presents to fellows in both Ghana and Nepal.

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Education

A snapshot into our residents, fellows, and allied healthcare professionals

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Curriculum Development

Several years ago, the Urogynecology team recognized the need for an updated training program to give the skills necessary to nurses, nurse practitioners, physiotherapists and others to care for patients with pelvic organ prolapse, incontinence, and other pelvic floor disorders.
With the support of the Mary Jo Robbins Endowment for Research and Innovation in Women’s Health, and the Royal Alexandra Hospital Foundation, the content of the Professional Development Certificate was written by Dr. Flood, Dr. Schulz and Dr. Slade and developed into
a postgraduate Professional Development Certificate run by MacEwan University. Future plans for the Certificate include translation into other languages.

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Conservative Management Options

Our first steps before surgery

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