The Transgender Dictionary

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Masculinized Vulva

Table of Contents

Introduction

This page is a W.I.P.!!! The information below was originally located on the pages for "Vulva" and "testosterone". They have been moved to this page for organization purposes. this page will be rewritten and reformatted in the future to be better to read/understand. for now it is just here in a disorganized manner so that the information is still available anyway. thank you for understanding :)

This messege will be removed when the page is fixed

General Information

Transgender men are men who were born with vulvas. This is something that will typically result in gender dysphoria. This is because having a vulva is not something that is traditionally associated with being a man. For many people, the idea of a man posessing a vulva is "wrong" or confusing. Its something that some people cannot quite wrap their head around. It can seem "wrong" to some. This "wrongness" is not unique to the outside observer. The vulva is an indicator of femininity that can make a trans man feel inadequate - like they aren't quite right.

Many transgender men will seek out surgeries to remove or reshape their vulvas to become more traditionally masculine. Most surgeons will require that the patient spends a certain length of time on testosterone; typically for optimal results though in some places this is a legal requirement. Some transgender men are unbothered with their anatomy and/or do not wish to undergo surgery, but still undergo GAHT. When a transmasculine individual goes on testosterone, this can cause various genital changes. Quite often, these are some of the first reported changes caused by GAHT.

One of said changes is enlargement of the clitoris, commonly referred to as "bottom growth." Size of bottom growth varies from person to person. Factors such as how big it will get, the appearance, and when it will stop growing will vary from person to person. Some transmasculine individuals report that it can get up to or even surpass 2 inches in length. Visually, bottom growth typically causes the clitoris to resemble a micropenis.

A few people report bottom grown being painful, due to the clitoris becoming more sensitive to chafing against clothing. Switching from traditionally feminine underwear to traditionally masculine underwear can help manage this issue. Some people use barriers such as aloe vera gel or baby powder to help with chafing.

Bottom growth is often (but not always) a prerequisite for surgeries such as phalloplasty and metoidioplasty, as it will give the surgeon more to work with.

It is possible to enhance bottom growth through the use of pumping devices. Sometimes surgeons will recommend it prior to surgery.

Some people will talk to their endocrinologist to get a specialized cream to enhance bottom growth. Some people who take their GAHT in gel form may think about putting it on their genitals to do this. As t-gel is alcohol based and has the consistency of hand sanitizer, this is a bad idea. Not only will it not work, but it will cause an extremely uncomfortable burning sensation.

While everyone should be cleaning their genitalia on a regular basis to maintain their personal hygiene, the enlargement of the clit can affect this routine for transgender men who are not quite used to the change. The area between the clitoris and the clitoral hood needs to be cleaned, but the sensitivity can cause it to be painful to touch when dry, which can sometimes discourage proper hygiene. I recommend making sure that the area is wet (with warm water) and possibly using a q-tip to reach the area for cleaning (if necessary)

Taking GAHT can also cause what is referred to as vaginal atrophy (referring to a dry vagina). The severity of this will vary from person to person, and will not necessarily happen. If/when it does happen, it can cause sexual intercourse to be painful.

It is important to note that atrophy can happen to people regardless of if they are on GAHT or not. This can happen to anyone, cis or trans, due to various reasons.

Some individuals will talk to an endocrinologist to get a specialized hormonal medication to help with this issue (typically in the form of a topical cream). Plenty of others will simply use lube. (Note - Regardless of who you are and what you are doing, improper lubricant during penetration can result in tearing, pain, and potentially future health complications. There is no shame in having to use it. Just have fun.)

Bottom Growth

There are many terms that an individual may use to refer to their own genitalia. These terms will vary based on personal preference. The more clinically acceptable terms for what will be discussed in this section are "bottom growth" and "clitoral enlargment."

The enlargment of the clitoris is often one of the first changes noticed after starting testosterone therapy. The appearance of this enlargment is similar to that of a micropenis. The clitoral hood will also grow, having the apperance of a prepuce. The labia may also grow. The patient may experience random erections.

This growth is often a prerequisite for surgeries such as metoidioplasty and phalloplasty.

If the patient stops taking testosterone, the clitoris will typically stay at the length and girth that it has grown to.

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Dihydrotestosterone Cream

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Vaginal Atrophy

Sometimes referred to as "vaginal dryness," vaginal atrophy (also known as atrophic vaginitis, genitourinary syndrome of menopause/GSM, or vulvovaginal atrophy) is the thinning and inflammation of the vaginal walls. This can occur when the body has less estrogen. Increased testosterone being introduced to the body suppresses estrogen production. Vaginal tissues are dependant on estrogen. Lower levels of estrogen decrease the vagina's ability to self-lubricate and keep the tissues as thick, supple, and stretchy as they may have previously been. Cisgender women can sometimes experience this when going through changes such as menopause or breast cancer treatment. For transgender men, it is a more common occurrence.

While on testosterone, vaginal tissues can become easily irritated, thin, and more sensitive to internal friction. This area can sometimes feel dry, burning, painful, and/or itchy (an experienced summarized by the medical term "atrophy"). Some people may experience small tears in the tissue. This atrophy can result in the patient being more prone to bacterial vaginosis and yeast infections. The urethra can also be more suseptible urinary tract infections (UTIs) or bladder infections.

Vaginal atrophy can be treated with estrogen to improve the patient's quality of life. The main types of hormal treatment offered are estrogen tablets, estrogen cream, or an estrogen vaginal ring. These treatments do not interfere with the effects of testosterone therapy, and simply deliver the low dose of replacement estrogen to the affected tissues, helping with internal lubrication and alleviating discomfort.

If you engage in sexual activity, and are uninterested in in taking perscription medication, using lubrication is greatly advised for personal comfort. The long-lasting lube known as "replens" is a non-hormonal non-medicated treatement for vaginal atrophy that helps cisgender women alike.

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Estrogen Cream

Estrogen cream is typically prescribed for daily use for the first 1-2 weeks, then used twice weekly afterward. Estrogen cream is inserted into the vagina using either a reusable or disposable applicator. If using a reusable applicator, be sure to keep it clean in between uses. Estrogen cream can be used both internally and on some of the external tissues for relief. Estrogen cream can sometimes be messy to use. The effectiveness of condoms, diaphragms, and cervical caps can be weakened if they are used within 72 hours of a dose of estrogen cream.

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>Estrogen Tablets

Estrogen tablets are small, approximately 6mm in diameter. A disposable applicator is included with the prescription to insert the tablet into the vagina daily for two weeks, and then twice weekly afterward. There is no mess with an estrogen tablet, but it can take hours to dissolve internally. The effectiveness of condoms, diaphragms, and cervical caps can be weakened if they are used within 72 hours of a dose of an estrogen tablet.

Trans-Masculine Specific Resources

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See also the pages for; neophallus, vulva, and packer.

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