Dihydrotestosterone (DHT) is a potent androgen hormone that plays a significant role in the development of male characteristics. For transgender men (trans men) and non-binary individuals assigned female at birth who undergo hormone therapy with testosterone, DHT can lead to various changes in the body. One of these changes is “bottom growth”, which refers to the enlargement of the clitoris, making it more similar to a small penis in size and function.
When testosterone is administered as part of hormone replacement therapy (HRT), it is partially converted into DHT by the enzyme 5-alpha reductase. DHT is more potent than testosterone in binding to androgen receptors and promoting the development of male secondary sexual characteristics.
Under the influence of DHT, the clitoral tissue can enlarge and elongate. This growth varies significantly among individuals, with some experiencing more noticeable changes than others.
Bottom growth typically begins within a few months of starting testosterone therapy, with the most significant changes occurring in the first year. However, growth can continue at a slower rate for several years.
The clitoris may become more sensitive during the initial stages of growth. This increased sensitivity can be uncomfortable for some individuals but often stabilises over time. The clitoris may develop a more phallic appearance and can become erect when aroused. This change can enhance sexual pleasure for some individuals.