: PDE5 inhibitors (like Sildenafil or Tadalafil) can often still be effective for trans feminine individuals.

: While the physical mechanism of an erection may become less reliable, many report that arousal becomes a more "whole-body" or emotional experience rather than a purely localized physical response. Post-Surgical Erectile Function (Phalloplasty)

: 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.

: A portion of the glans penis is often used to create a neo-clitoris. This tissue can still engorge with blood during arousal, providing a sensation similar to a natural clitoral erection.

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:

: The skin and tissue of the penis may become softer or thinner over time due to androgen deprivation.

: These consist of a pump (usually placed in the scrotum) and a reservoir. Pumping the device moves fluid into a cylinder within the phallus to create an erection.

: When erections do occur, they are often less rigid than before hormone therapy.