Clitoral growth, often referred to as “bottom growth,” is one of the most significant physical changes experienced by trans men undergoing testosterone hormone therapy.
This change can be an affirming and empowering aspect of gender transition, providing many trans men with a greater sense of alignment between their body and gender identity.
At the same time, it can also bring challenges, such as adjusting to new sensations, navigating potential discomfort, or addressing feelings of dysphoria. This article provides a detailed look at what clitoral growth involves, its physical and emotional effects, and how to manage and embrace these changes.
What is clitoral growth?
Clitoral growth refers to the enlargement of the clitoral tissue as a result of testosterone therapy. The clitoris and penis are homologous structures, meaning they develop from the same tissues in the womb.
When exposed to testosterone, the clitoral tissue grows in response to the hormone, similar to how the penis develops during puberty in cisgender boys.
The typical range of clitoral growth varies between individuals, with most experiencing an increase of 1-3 centimetres in length. Factors like genetics, dosage, and the duration of testosterone therapy influence the extent of growth. This growth may also be known as clitoral hypertrophy or clitoromegaly.
Growth typically begins within the first few months of starting testosterone and can continue to develop gradually over the course of one to two years before stabilising. While the increase in size is often modest compared to the penis, it can significantly alter how the clitoris feels and functions.
Physical effects of bottom growth
One of the most immediate changes noticed during bottom growth is increased sensitivity in the clitoral tissue. Testosterone enhances blood flow and nerve responsiveness, making the clitoris more reactive to touch.
For many trans men, this heightened sensitivity leads to enhanced sexual pleasure and can make masturbation or sex more enjoyable.
However, this increased sensitivity can also have its challenges. For some, the clitoris becomes so sensitive that direct stimulation feels uncomfortable or even painful. This heightened responsiveness can also cause irritation during daily activities, such as walking, cycling, or wearing tight clothing.
Adjusting to these changes can take time, but with the right tools and strategies, most trans men find ways to manage sensitivity and embrace the benefits of bottom growth.
Navigating sensitivity and discomfort
Managing the increased sensitivity of bottom growth is key to staying comfortable and maintaining a positive relationship with your body.
Lubricants
Whether for masturbation, sex, or reducing friction during daily activities, lubricants can be invaluable. Water-based and silicone-based lubricants are ideal for sensitive tissue, reducing discomfort caused by dryness or friction. Vaginal atrophy can be a persistent problem for trans men on testosterone therapy.
Indirect stimulation
If direct contact with the clitoris feels too intense, exploring indirect forms of stimulation can help. This might involve touching surrounding areas, using a barrier like underwear or fabric, or experimenting with vibrations at lower intensities.
Clothing choices
Tight clothing, such as skinny jeans or snug underwear, can sometimes irritate the clitoral tissue. Switching to looser-fitting underwear or softer fabrics can minimise discomfort.
Some trans men find jockstraps or specialised gender-affirming undergarments helpful in providing comfort and support.
The psychological and emotional impact of bottom growth
For many trans men, clitoral growth can be an incredibly affirming experience. The physical changes brought on by testosterone often help create a deeper sense of alignment between one’s body and gender identity, contributing to greater confidence and comfort.
Enhanced clitoral sensitivity and functionality can also foster a more positive connection to one’s sexual health.
However, these changes can also bring up complicated feelings for those who experience dysphoria related to their genitalia.
Bottom growth might highlight areas of the body that don’t fully align with one’s ideal sense of self, causing discomfort or distress. It’s important to recognise that these feelings are valid and part of a complex journey.
Strategies to address these emotions might include:
- Viewing bottom growth as a step toward personal goals rather than as an end state.
- Celebrating the positive aspects of growth and the progress being made on your transition journey.
- Talking with other trans men who have experienced bottom growth can provide reassurance and practical advice. Therapists or counsellors experienced in gender-affirming care can also help you navigate these feelings.
Sexual exploration and pleasure
As clitoral growth progresses, it can open new possibilities for sexual pleasure and exploration. The enhanced sensitivity and increased size may allow for new types of stimulation or techniques during masturbation and sex.
Masturbation
Experimenting with different methods of self-pleasure can help you discover what feels best. You might try using your hands, sex toys, or even gentle water pressure from a showerhead. Take your time to explore, and don’t be afraid to adjust based on your comfort level.
Exploration with a partner
Communicating with sexual partners about your preferences and boundaries is essential. Let your partner know what feels good and what doesn’t. Open dialogue fosters trust and ensures that your needs are respected.
Using sex toys
Vibrators, strokers, or other toys designed for smaller genitals can be excellent tools for enhancing pleasure. Look for products with adjustable settings to accommodate sensitivity and explore different sensations.
When to seek medical advice
While clitoral growth is a normal part of testosterone therapy, it’s important to pay attention to your body and seek medical advice if something feels off. Symptoms like unusual pain, persistent inflammation, or irritation that doesn’t improve with simple adjustments might indicate an issue that needs attention.
Talking to a healthcare provider can feel intimidating, especially when discussing sensitive topics. Look for transgender-friendly providers who understand the unique needs of trans men and can offer affirming care.
If you feel uncomfortable, bring a list of your concerns to help guide the conversation, or consider seeking support from trans advocacy groups to find a trusted provider.
Caring for yourself
Clitoral growth, or bottom growth, is a natural and empowering part of many trans men’s journeys on testosterone. While it brings significant physical changes, it also presents opportunities for personal growth and exploration.
By understanding what to expect, learning how to manage sensitivity or discomfort, and embracing the possibilities for pleasure, trans men can navigate this change with confidence and self-compassion.
Bottom growth is a testament to the transformative power of testosterone and a step toward living authentically in your body. With the right tools, knowledge, and support, you can make this part of your transition a positive and affirming experience.
References1–4
- 1.Holmberg M, Arver S, Dhejne C. Supporting sexuality and improving sexual function in transgender persons. Nat Rev Urol. Published online October 30, 2018:121-139. doi:10.1038/s41585-018-0108-8
- 2.Dimakopoulou A, Seal LJ. Testosterone and other treatments for transgender males and non-binary trans masculine individuals. Best Practice & Research Clinical Endocrinology & Metabolism. Published online September 2024:101908. doi:10.1016/j.beem.2024.101908
- 3.Irwig MS. Testosterone therapy for transgender men. The Lancet Diabetes & Endocrinology. Published online April 2017:301-311. doi:10.1016/s2213-8587(16)00036-x
- 4.Grimstad F, Boskey ER, Taghinia A, Estrada CR, Ganor O. The role of androgens in clitorophallus development and possible applications to transgender patients. Andrology. Published online April 23, 2021:1719-1728. doi:10.1111/andr.13016
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