The side effects of testosterone for transgender men are often overlooked and under-researched. Urinary incontinence in the form of overactive bladder disorder, stress incontinence, and mixed incontinence may arise or be exacerbated by use of testosterone. Using menopause and other similar hormonal transitions such as pregnancy as a reference, the purpose of this thesis is to fully understand the effects of testosterone replacement therapy on transgender people assigned female at birth, and to fully understand the effect of testosterone replacement therapy on the pelvic floor and why there is a potential increased incidence of urinary incontinence. Menopause and pregnancy are used as reference because these are hormonal transitions associated with a decrease in estrogen levels. The decrease in estrogen causes a looseness in the connective tissue structures, which leads to a lack of support in the pelvic floor muscles, causing a urinary incontinence. With a comparison between menopause, pregnancy, and testosterone replacement therapy established, potential solutions to stress urinary incontinence and overactive bladder disorder will be explored.

Sex is a biologically based classification, determining whether an individual is male or female. Comparatively, gender is a socially designed construct, which varies between cultures and prescribes what it means to be a man or a woman. Western culture suggests all individuals fall neatly into one of these two groups. Females are expected to display feminine characteristics such as being nurturers, while males are expected to display masculine characteristics such as being providers. There exists, however, a population of individuals who identify themselves as "transgender," meaning, they feel inconsistency between their internal sense of gender identity and their birth-assigned biological sex and/or assigned gender role. These individuals wish to separate from their birth-assigned gender role and express through physical modification their true gender identity. In the context of romantic relationships, it was once thought that disclosure of one partner's transgender identity meant inevitable demise of the relationship. Clinical guidelines offered advice to the transgender partner, suggesting they abandon their family, change their identity, and begin a new life elsewhere (Lev, 2004). More recently, however, clinical experiences suggest the possibility that many transgender people can maintain healthy and sustainable relationships. This study sought to understand the impact of gender transition on the sexual relationship and sexual orientation of female-to-male (FTM) transgender individuals and their cisgender female partners. / Master of Science