For transgender men (AFAB) who undergo phalloplasty (the surgical creation of a phallus), the new genitalia do not contain erectile tissue (corpora cavernosa) and cannot become erect on their own. To achieve rigidity for penetrative intercourse, an is typically implanted after the initial phallus has healed:
: When erections do occur, they are often less rigid than before hormone therapy.
For transgender women (AMAB) undergoing feminizing hormone therapy, the introduction of estrogen and the suppression of testosterone typically result in significant changes to erectile function: transsexual erections
: PDE5 inhibitors (like Sildenafil or Tadalafil) can often still be effective for trans feminine individuals.
For transgender women who undergo vaginoplasty, the erectile tissue is typically reduced or repurposed. For transgender men (AFAB) who undergo phalloplasty (the
: In some cases, a low-dose topical testosterone cream applied directly to the genitalia can help maintain tissue health and function without significantly affecting systemic hormone levels.
: These are firm but flexible rods that allow the phallus to be manually positioned upward for sex or downward for concealment. For transgender women who undergo vaginoplasty, the erectile
This overview addresses the physiological aspects of erections for transgender individuals, specifically focusing on how gender-affirming hormone therapy (GAHT) and various surgical procedures influence erectile function. Hormonal Effects on Native Genitalia