Body masculinization

    Body masculinization describes changes a person may seek for a more masculine body contour. Goals may involve the chest, waist, hips, muscle distribution or body hair. There is no required sequence or combination of treatments.

    Last reviewed: November 20265 sources

    What you may notice

    • Interest in a flatter chest
    • A wish to change waist or hip contour
    • Goals involving muscle or body hair
    • Distress about particular body features

    Why it can happen

    Body contour reflects inherited anatomy, breast tissue, fat and muscle. Testosterone can change fat distribution, muscle mass and body hair, but effects vary. Hormones and exercise do not reliably create a flat chest or replace chest surgery when that is the person’s goal.

    What may help

    Options may include clothing, exercise, supervised hormone therapy or selected surgery. Chest surgery and body contouring have different aims and risks. Chest procedures can change nipple sensation and leave permanent scars; revisions may be needed. Hormones and surgery are optional, and their timing should be individualised.

    When to consult

    Consult clinicians experienced in gender-affirming care to discuss goals, monitoring and recovery. Discuss fertility and lasting effects before hormone treatment when relevant. A new chest lump or other unexplained symptom needs medical assessment, including after chest surgery.

    Related options

    6 options

    Surgical procedures

    Evidence and sources

    1. Coleman E, Radix AE, Bouman WP, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022;23(Suppl 1):S1-S259. doi: 10.1080/26895269.2022.2100644.
    2. National Health Service. Gender dysphoria and incongruence [Internet]. London: National Health Service; 2026 [cited 2026 Nov 7]. Available from: https://www.nhs.uk/conditions/gender-dysphoria-and-incongruence/
    3. American Society of Plastic Surgeons. Gender surgeries [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/reconstructive-procedures/gender-surgeries
    4. UCSF Gender Affirming Health Program. Overview of masculinizing hormone therapy [Internet]. San Francisco (CA): University of California, San Francisco; [cited 2026 Nov 7]. Available from: https://transcare.ucsf.edu/guidelines/masculinizing-therapy
    5. American Society of Plastic Surgeons. Chest masculinization surgery risks and safety [Internet]. Arlington Heights (IL): American Society of Plastic Surgeons; [cited 2026 Nov 7]. Available from: https://www.plasticsurgery.org/reconstructive-procedures/chest-masculinization-surgery/safety