These Sims 4 Transgender Mods Make Your Save Files More Inclusive

We independently assess all our recommendations. Purchases through our links may earn us a commission.

Where are all the Sims 4 transgender mods? It’s been nearly a decade since the Sims 4 was released in September 2014 so it’s no surprise that the game has everything from farming to transgender mods to help make your game feel more realistic. While Sims 4 sims were always capable of feeling romantic attraction to sims of any gender, we haven’t really gotten official content that specifically tries to help you achieve a realistic trans playthrough.

When it comes to making transgender sims, fans of the game are mostly on their own which is why these transgender mods and custom content were developed by other fans over the past few years. 

A word of warning: Mods and custom content tend to break if they aren’t updated to work with the latest version of the game so by the time you’re reading this, there’s a chance some of these mods and custom content no longer work. If that’s the case, we have tips on how you can make a transgender sim without needing these Sims 4 transgender mods. 

Sims 4 Transgender Mods to Check Out 

Zero’s Mental Health Mod 

Zero’s mods are currently some of the best Sims 4 transgender mods available online, mainly because they’re new and are still being maintained so you can count on them being functional should you decide to install them. 

One of their more popular mods is a Mental Health mod that lets you set mental health issues and disorders for your sim. Among the options is the ability to give your sims Gender Dysphoria. This can only be fixed by giving your sim Hormone Replacement Therapy. Your sim can also go to counseling, join support groups, or develop bad coping mechanisms involving substance abuse. Your pick.

To be clear, Zero’s mental health mod isn’t meant to be an accurate representation of mental health problems and does not intend to portray transgender people’s way of being as mentally ill. As per the NHS, Gender Dysphoria refers to the distress felt by a person when there’s a mismatch between their biological sex and their gender identity.

Since we’ve already mentioned it,  let’s move on to the Hormone Replacement Therapy (HRT) mod.

Zero’s HRT Mod

Zero’s Hormone Replacement Therapy mod lets you simulate what it’s like to transition using your sim. The mod adds three new consumable items that your transgender sim can purchase with their computer. 

These are Tostran 2% Gel (Testosterone), EstadiolGel 0.1% Gel (Estrogen), and an Anti-androgen treatment that blocks the conversion of testosterone to dihydrotestosterone, or so the mod says. 

The HRT items are pretty cheap too, especially if you compare them to real-life treatments. They only cost 50 simoleons each and are super accessible.

That said, you still need a doctor’s prescription to get your hormones in this game. Fortunately, all you have to do to unlock them is to research HRT online using your phone or computer and book an appointment with a doctor using your sim’s phone. The prescription will cost 375 simoleons.

This mod is designed to interact with the Wicked Whims mod so a sim who starts taking testosterone should lose their period in the Wicked Whims mod. 

Meep62’s Gender Transition Mod

If there’s one thing Sims 4 players like us have learned to accept, it’s that we can’t get all the features we want in one mod or official expansion. Sometimes, you just gotta mix and match to get the best results. 

If you want to incorporate top and bottom surgery into your game for a more realistic transgender sim playthrough, you might want to consider installing Meep62’s Gender Transition mod.

Well, mods. There are actually three versions of the Gender Transition Mod. the first one lets you “Go to Voice Training” which changes your sim’s voice from masculine to feminine and vice versa. It also comes with a “Take Hormones” interaction, but the effect is instant rather than gradual like the one you get with Zero’s HRT mod. 

The second version functions mostly the same except your sim’s voice automatically changes when they take hormones while the third one removes voice training altogether. If you have a mod already installed to take care of some of those features, you might want to opt for the more minimal version of the Gender Transition Mod. 

PimpMySims4’s LGBT Mod

PimpMySims 4 may be a fairly new Sims 4 modder, but they’ve already made one of the most detailed LGBT mods in the game. Their LGBT mod has translations available for Polish, German, and Russian on top of the default English.

The mod lets you add an identity for your sim in Create A Sim in the form of traits. These traits include Aromantic, Asexual, Bisexual, Demisexual, Gay, Gender Fluid, Lesbian, Non-Binary, Pansexual, and, of course, Transgender. Sims can also be given traits such as Ally, LGBT Activist, Drag Queen/King, or Questioning which are all pretty handy if you want to give your sims a more complicated story of self-discovery. 

If you don’t mind negative realism, there’s even an option to include a homophobic/transphobic file that makes other sims get Uncomfortable moodlets when they’re around your sim.

Zero’s Force Breasts Mod

It’s almost like Zero is carrying the entire Sims 4 transgender mods category with this third mod of theirs making the list. 

The Force Breasts mod, unfortunately, has nothing to do with Star Wars but it does give your sims breasts which is almost as cool. The mod tries to account for, in Zero’s words, differences in male and female torso proportions that hormones can’t change as well as differences in proportions of the face’s jaw, mouth, and nose. 

A cool benefit of the mod is that you can use female clothing options on an FtM sim because we all know Sims 4’s official clothing options for male sims tend to suck. 

Sims 4 Transgender Custom Content

Cloudy Simmers’ Female Trans Scars

While the transgender mods for the Sims 4 mentioned above tend to work pretty well, there are limited options for giving your sims scars related to their transition. Cloudy simmers has these MtF scars that you can add to your sims to indicate they had breast augmentation surgery. 

Cloudy Simmers’ Male Trans Scars

Cloudy Simmers giveth and Cloudy Simmers taketh away. Their MtF scars can be added to sims who had top surgery for breast removal. 

Schmapple’s Binders

Before you get too excited, these aren’t functional binders. I did find a link to a functional binder on Reddit, but it lead to a dead end so no functional binders for us simmers. 

The second best thing is to use Schmapple’s binders which work on sims of all genders. Of course, you’ll have to play around with the chest sliders in Create A Sim, but it’s not bad at all given how nice these binders look in the game. Hey, if you don’t want to use them as binders, they could serve as sports bras. We won’t tell. 

Don’t Want to Install Mods? Use Create A Sim!

Installing mods can be intimidating if you aren’t used to going through your computer’s files and/or don’t want the risk of downloading a shady mod that turns out to be malware. In those cases, you can try opening Create A Sim and switching between the male and female body types. There are also options for specifying that your sim can get others pregnant or get pregnant themselves as well as settings for letting your sims pee standing up or sitting down.