A Preliminary Review of Effects of Bladder Integrity (Urinary Incontinence) Following Gender Affirming Surgery in Transwomen: Two Case Studies

Transwomen narratives about their unique living experiences are an important tool for assisting healthcare workers to better understand how to help these women gain control of their symptoms. No previous type of study could be found that focused on the meaning of transwomen’s experience of living with urinary incontinence (UI) from a symptom management perspective or how the gender affirming surgery (GAS) effects bladder integrity or UI. Through a case study of two transwomen a story unfolded: the devastating informative effects of living with UI, dealing with healthcare systems and providers, the patronizing and ineffective informed consents endured to receive care, and missed healthcare issues that were not uncovered by healthcare professionals due to unasked questions on both sides. The gaps in the literature are evident, as are the effects of their transition, aside from the additional medical effects from the surgical process. The aim was to highlight the meaning of transwomen’s experience with bladder integrity and potential UI issues following GAS, and to discover if any subsequent bladder issues are routinely addressed by healthcare workers; care-seeking behaviors were explored. The two 60-75 year old informants’ experiences were presented in terms of inter-related themes as being in a vulnerable position with UI and striving for adjustment to being transgender while dealing with UI symptomology. UI as a potential side effect of GAS ought to be discussed as part of informed consent prior to surgery. Providers should offer education as to both the potential complications of UI and realistic outcomes prior to GAS.