Sexual Health for Pelvic Health Physiotherapists | Transcend Training Institute

Transcend Training Institute

Your clinical training
covered the body.
Not the whole picture.

Pelvic health physiotherapists regularly encounter sexual dysfunction, sexual pain, trauma, and relational distress in clinical practice. Most received no training in the psychological and relational dimensions of these presentations. This program addresses that directly.

View the course Why this matters
6+
Hours of continuing professional development designed specifically for pelvic health physiotherapists
CPD
Counts toward your continuing professional development obligations -- no mandatory quota, but your college expects you to keep records
Developed by registered psychologists with specialized practices in sexual health and pelvic pain, in collaboration with Dr. Sanja Kostov, MD, CCFP, FCFP
Professional development in sexual health for pelvic health physiotherapists with online course dashboard and clinical tools
Foundational course
Sexual Health for Pelvic Health Physiotherapists
~6 hours · Self-paced online
The psychological, relational, and trauma dimensions of sexual health -- built around what pelvic health PTs actually encounter in practice.
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Short courses
Targeted CPD Modules
30–60 min each · Available individually
Focused modules on specific clinical challenges: trauma-informed care, working with shame, communication across the care team, and more.
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 Interdisciplinary care icon connecting research, assessment, medical care, and clinical documentation
Interdisciplinary
Built for the Care Team
Designed for collaborative practice
Designed to strengthen the clinical bridge between pelvic health physiotherapy and sex therapy. Better for patients. Better for both disciplines.
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The clinical reality

Pelvic health physio and
sexual health are
inseparable.

"Pelvic health physio and sexual health are inseparable."

Pelvic health physiotherapists are often the first clinician a patient with sexual pain trusts enough to disclose to. The clinical encounter is intimate, the presentations are complex, and the patients who arrive have frequently been dismissed by other providers for years before reaching a pelvic health PT.

And yet most pelvic health physiotherapy training focuses on musculoskeletal anatomy, internal examination, and physical treatment protocols. The psychological and relational dimensions of the presentations in the room -- shame, trauma history, relationship dynamics, fear-avoidance cycles, and the patient's beliefs about their own body -- are largely left to develop informally, if at all.

This program does not teach physiotherapy. It teaches the clinical knowledge that makes physiotherapy more effective when the patient in front of you is also navigating sexual pain, trauma, or relational distress.

Trauma-informed practice icon with protective hands and nervous system symbolism
Trauma is the rule, not the exception
Research consistently documents high rates of sexual and medical trauma in patients presenting with pelvic pain and sexual dysfunction. Recognizing trauma presentations, pacing clinical encounters appropriately, and avoiding re-traumatization are clinical skills -- not intuitions.
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The fear-avoidance cycle is your primary target
In genito-pelvic pain presentations, the pain-avoidance cycle -- pain, anticipatory anxiety, pelvic floor guarding, reduced arousal, increased pain -- is self-reinforcing and maintained psychologically as much as physically. Understanding this cycle improves physical treatment outcomes.
3
Shame actively interferes with treatment
Patients with sexual pain carry significant shame -- about their bodies, about their diagnosis, about disclosing to a partner. Shame that is unaddressed reduces homework compliance, increases avoidance, and lengthens treatment. Recognizing and responding to shame is a clinical skill.
4
Partners and relationships affect outcomes
Sexual pain does not occur in a relational vacuum. Partner responses -- supportive or not -- significantly affect treatment engagement and outcomes. Knowing when and how to involve a partner, and when to refer to a sex therapist for relational work, is part of effective case management.
Interdisciplinary care icon connecting research, assessment, medical care, and clinical documentation
Referral requires knowing what to refer to
Effective referral to sex therapy, psychology, or pelvic pain medicine requires understanding what each discipline offers. Vague referrals get poor follow-through. Clear, formulation-informed referrals that explain what the receiving clinician can offer produce better outcomes for everyone.

CPD in Canada

How CPD works
for Canadian
physiotherapists.

Unlike CME for physicians, Canadian physiotherapy colleges do not mandate a specific number of CPD hours or prescribe what types of education count. You are expected to identify your own learning needs, develop a learning plan, and maintain a record of your CPD activities.

This program counts as continuing professional development. It directly addresses a documented gap in pelvic health physiotherapy training and is immediately applicable to clinical practice. It is not accredited by a physiotherapy college -- no Canadian college approves or endorses specific courses -- but it is substantive, evidence-based, and professionally appropriate to include in your CPD record.

Note that regulations vary by province. Pelvic health physiotherapy, including internal examination, requires specific authorization in some provinces. This program does not address authorization requirements for internal examination -- consult your provincial college for that guidance.

A note on accreditation
The College of Physiotherapists of Ontario states that physiotherapists are expected to "identify your own learning goals, come up with a learning plan, and reflect on your learning." No specific course types or hours are mandated. Similar self-directed CPD frameworks apply in most Canadian provinces.
Provincial variation
The Canadian Physiotherapy Association's Pelvic and Reproductive Health Division (formerly the Women's Health Division) is the national professional home for pelvic health PTs. Individual provincial colleges -- the College of Physiotherapists of Alberta, the College of Physiotherapists of Ontario, and others -- govern authorization requirements for pelvic health practice including internal examination. Requirements differ by province.
No curriculum standard
The Canadian Physiotherapy Association has noted that there is currently no specific pelvic floor physiotherapy curriculum in Canada and that course content differs between providers. This program addresses the sexual health and psychological dimensions of pelvic health practice -- a documented gap in existing post-graduate offerings.

The foundational course

Sexual Health for
Pelvic Health PTs.
~6 hours.

Six modules covering the psychological, relational, and trauma dimensions of sexual health practice. Not anatomy. Not assessment protocols. The clinical knowledge that sits alongside your existing physiotherapy skills and makes them more effective.

01
The Psychology of Sexual Pain
The fear-avoidance cycle as the primary maintaining mechanism in genito-pelvic pain; central sensitization and the neurobiological basis of pain amplification; the psychological consequences of diagnostic delay and clinical dismissal; how psychological state directly affects pelvic floor tone and treatment response.
Fear-avoidanceCentral sensitizationDiagnostic dismissalPain neuroscience
~60 min
02
Trauma-Informed Pelvic Health Practice
Trauma as a predisposing and perpetuating factor in pelvic pain and sexual dysfunction; the Window of Tolerance and its direct relevance to internal examination; universal precautions in clinical practice; recognizing trauma presentations without requiring disclosure; pacing, titration, and creating safety in clinical encounters. What to do when a patient becomes dysregulated during assessment or treatment.
Window of toleranceUniversal precautionsDysregulationClinical pacing
~75 min
03
Sexual Response, Arousal, and Desire
How sexual arousal affects pelvic floor function and tissue state; the Dual Control Model of excitation and inhibition and why it matters for treatment planning; the distinction between spontaneous and responsive desire and its clinical relevance; arousal non-concordance and its implications for patients who experience genital response during unwanted contact; shame as an inhibitory mechanism that directly suppresses arousal and increases pelvic floor tension.
Dual control modelArousal and tissue stateNon-concordanceShame and SIS
~60 min
04
Shame, Communication, and the Clinical Environment
Why patients with pelvic pain and sexual dysfunction carry disproportionate shame; how shame affects disclosure, homework compliance, and treatment engagement; clinical language that does not embed normative assumptions; how to raise sexual health in a clinical encounter without inadvertent pathologizing; communication frameworks for sensitive disclosures; the clinical environment as a therapeutic variable.
Shame and complianceClinical languageSensitive disclosureNon-pathologizing
~45 min
05
Partners, Relationships, and Relational Dynamics
How partner responses affect treatment outcomes in sexual pain presentations; desire discrepancy as a common relational context for pelvic pain referrals; the clinical decision of when to involve a partner and when to defer to sex therapy; what to say to a patient whose partner is applying pressure around sexual activity during treatment; common relational patterns that impede recovery and how to recognize them.
Partner impactDesire discrepancyRelational dynamicsTreatment interference
~45 min
06
Referral, Collaboration, and the Care Team
What sex therapy, psychology, sexual medicine, and pain psychology each offer; when a presentation exceeds physiotherapy scope and how to recognize it; how to frame a referral so patients follow through; what a sex therapist needs to know from a physiotherapy referral and vice versa; communication across the care team; how collaborative care produces better outcomes than parallel siloed treatment.
Referral pathwaysSex therapy scopeCollaborative careInterprofessional
~45 min
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Short courses

Targeted CPD.
Single sessions.

Focused 30–60 minute modules on specific clinical challenges. Available individually. Designed for physiotherapists who want to develop a particular competency without completing the full foundational course.

When a Patient Discloses Sexual Trauma
~45 min
What to say, what not to say, how to pace the remainder of the session, and what to document. Practical guidance for one of the most common and most undertrained clinical scenarios in pelvic health practice.
Working with Shame in Pelvic Health
~30 min
Recognizing shame in how patients present, speak, and comply with treatment. Clinical language that reduces rather than compounds shame. How the clinical environment communicates safety before a word is spoken.
Communicating Across the Care Team
~30 min
How to write a referral to a sex therapist that produces a useful consultation. What information a psychologist or sex therapist needs from a physio referral. How to communicate clinical findings across disciplines without pathologizing language.
The Fear-Avoidance Cycle: Clinical Application
~45 min
How to explain the pain-avoidance cycle to a patient in session. Practical psychoeducation frameworks. How to use the cycle model to frame treatment rationale and improve homework compliance.
Pain Neuroscience for Sexual Pain Presentations
~45 min
Central sensitization, neuroplasticity, and top-down modulation explained for clinical use. How to deliver pain neuroscience education in the context of sexual pain without minimizing physical contributors or reinforcing psychologization.
Consent, Boundaries, and Sensitive Examination
~30 min
Informed consent as an ongoing process in pelvic health practice. What ongoing consent looks like in internal examination. How to structure a clinical encounter so that patients feel genuinely able to pause, modify, or stop.

Why this matters

The best outcomes happen
when the care team
speaks the same language.

Sexual pain is biopsychosocial by definition. The research is clear: combined physiotherapy and psychological treatment produces better outcomes than either alone. That collaboration works best when both clinicians understand each other's framework.

What physiotherapists bring
The body as the clinical target
Pelvic floor assessment, internal examination, manual therapy, progressive loading, and biofeedback. The physiotherapist addresses the physical mechanisms that maintain sexual pain -- hypertonicity, tissue sensitization, coordination deficits -- in ways that psychological treatment alone cannot reach.
What this program adds
The psychological and relational context
Understanding why the fear-avoidance cycle persists even when physical treatment is technically sound. Recognizing when trauma history is driving avoidance. Knowing when to refer and how to frame it. Speaking the clinical language of sex therapy and psychology well enough to collaborate effectively across the care team.

Strengthen the clinical bridge
between pelvic health physio
and sex therapy.

Trauma-informed, relationally aware, interdisciplinary sexual health CPD for pelvic health physiotherapists.

This program provides continuing professional development in the psychological and relational dimensions of sexual health. It does not address authorization requirements for pelvic health internal examination -- consult your provincial college for guidance on those requirements. Regulations vary by province.

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