Vaginoplasty: What to Expect and How Pelvic Floor Physiotherapy Can Support You

by Natasha Amsden  MScPT
Registered Physiotherapist
updated Mar 16, 2026

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Vaginoplasty is a gender affirming surgery that can be an important step in helping your body align with your gender identity. For many people, it plays a powerful role in reducing gender dysphoria, improving self confidence, and supporting emotional well being. If you’re considering vaginoplasty or preparing for surgery, you’re not alone, and there is support available every step of the way.

 

What Is Vaginoplasty?

In Ontario, the most common type of vaginoplasty is called penile inversion vaginoplasty. This procedure is designed to create genital anatomy that looks, feels, and functions like a vulva and vagina.

After surgery, many people can expect:

• A vaginal canal with enough depth for penetrative sex
• A clitoris created from the sensitive tissue of the head of the penis, allowing for sexual sensation
• A clitoral hood
• Labia minora and labia majora
• Erogenous areas with the potential for pleasure

If penetrative sex isn’t a goal for you, there is also an option called vulvoplasty or zero-depth surgery. This creates the appearance of a vaginal opening without an internal canal. This can be a great option for people who want external genital affirmation without the need for dilation afterward.

 

What Happens During Surgery?

Penile inversion vaginoplasty involves several surgical steps that work together to create the vagina and vulva. These include:

• Removal of the testicles (orchiectomy)
• Removal of erectile tissue (penectomy)
• Shortening and repositioning of the urethra (urethroplasty)
• Creation of the vaginal canal using penile skin
• Creation of a clitoris using sensitive tissue from the head of the penis
• Formation of the labia

There are other surgical techniques, such as intestinal or peritoneal vaginoplasty, but these options are not currently offered in Ontario.

 

How Can Pelvic Floor Physiotherapy Help?

Pelvic floor physiotherapy can be an incredibly helpful part of your care, both before and after surgery.

Before Surgery

Pre-operative physiotherapy is all about preparing your body for surgery and recovery. This may include:

• Improving bowel and bladder habits
• Learning breathing techniques that support relaxation and healing
• Building general strength and conditioning
• Improving hip and pelvic mobility
• Strengthening your core
• Learning how to control and relax your pelvic floor
• Talking through realistic post-surgery goals
• Being familiar with your body ahead of surgery can make recovery feel more manageable and empowering.

After Surgery

Post-operative pelvic floor physiotherapy is key to helping you heal well and feel more comfortable as your body recovers. A pelvic floor physiotherapist can help with:

• Managing swelling and pain
• Scar tissue care
• Restoring hip and pelvic movement
• Preventing or managing constipation
• Guiding you on safe activity progression

One of the most important parts of recovery after vaginoplasty is vaginal dilation.

 

Support With Vaginal Dilation

Dilation helps maintain the depth and width of your new vaginal canal. Because the body naturally wants to heal by closing the canal, following a regular dilation schedule is essential, especially in the early months after surgery.

A pelvic floor physiotherapist can support you by:

• Teaching you how to use dilators safely and comfortably
• Helping you learn techniques to relax your pelvic floor and reduce discomfort
• Guiding you on when and how to progress to larger dilators
• Helping you recognize signs that something may not be healing as expected

You don’t have to figure this out on your own. Having guidance can make dilation feel less stressful and more manageable.

 

You Deserve Support

Vaginoplasty is not just a surgical journey, it’s a whole-body and emotional experience. Pelvic floor physiotherapy is one way to ensure you feel supported, informed, and confident as you prepare for surgery and heal afterward.

If you’re thinking about vaginoplasty or are already scheduled for surgery, working with a pelvic floor physiotherapist can help you feel more prepared, more comfortable, and more in control of your recovery.