Nonbinary Life

The Sims 4 trans update: Now Sims can have top surgery scars, binders, and shapewear

I am a long time Sims fan, which means I am very excited about The Sims 4 trans update. I’ve been playing The Sims since the original, when I could check the CD-ROM out of the library and play it on our desktop computer for two weeks at a time. I was devastated as a child when The Sims 2 wouldn’t run on our home computer. I had the original Sims, Sim City, Sim Farm, Sim Ant, Sim Tower, the list goes on. Lots of slightly weird, slightly obsessive fun.

I started playing The Sims again as an adult about a month ago, when I discovered The Sims 4 was now free-to-play. Honestly, I was delighted by the gender-inclusive options for designing characters in this version of the base game, even before this week’s new Sims 4 trans update. Now your Sims can have top surgery scars and wear binders and shapewear — pretty cool! The same update included medical wearables: hearing aids and glucose monitors.

This post is all about the new Sims 4 trans update, and also, the trans-inclusive features this game has in general!

The Sims 4: Trans Update
Screenshot from The Sims 4

Hi, I’m Rey, a nonbinary writer! Please subscribe for more stories and resources:


I like making Sim households with queer relationships, chosen family, platonic roommates, and close friends. Part of the appeal of The Sims is seeing these households and people succeed, find love and friendship, make money, live in dream homes…

Five Sims in a living room chatting
Screenshot from The Sims 4

The Sims 4 Trans Update — Gameplay Details

The Sims 4 now has options for top surgery scars, shapewear, and binders! This is a base game update, meaning all users received these features in an update. The Sims 4 has many unofficial mods and custom content (some will even help your Sim have a gender transition) but it’s especially meaningful to have these trans-inclusive features built into the base game.

Top surgery scars are now an option to choose for your Sim’s body. These will show up if your Sim is not wearing a shirt (for example, in swim trunks).

Character creation screen showing a Sim with top surgery scars on a square chest.
Screenshot from The Sims 4

If you want to add top surgery scars to a body with hips wider than shoulders, it seems the best way to do that in the game is to use the dropdown for more gender options (shown in the following screenshot). Select “Feminine” physical frame.

Character creation screen showing a Sim with top surgery scars and chest hair on a body that's wider at the hips than the shoulders.
Screenshot from The Sims 4

The option for your Sim to wear a binder is available under shirts. It’s an item of clothing, meaning, you can’t layer another shirt over the binder. The binder comes in several different color options including a variety of skin tones and colorful patterns.

Character creation screen showing a Sim with flat chest wearing a binder.
Screenshot from The Sims 4

The binder item of clothing is available for all body types. It really is just a Sim “item of clothing”, meaning, it doesn’t change the shape of the Sim’s body when they are wearing it. This is frustrating for some players who would prefer the binder to shape the Sim’s body. On the other hand, perhaps it could also be realistic for a binder to show a larger chest and not magically change the body shape. Anyway, if you want your Sim to have a flat chest, you have to choose that option separate from the binder.

Character creation screen showing a Sim with curved, larger chest wearing a binder.
Screenshot from The Sims 4

The Sims 4 trans update also includes shapewear! A new underwear option which comes in multiple colors.

Character creation screen showing a Sim wearing a rainbow flag t-shirt and shapewear as underwear.
Screenshot from The Sims 4

Character creation screen showing a Sim wearing a pink shirt and teal shapewear as underwear.
Screenshot from The Sims 4

Gender Inclusive Options in The Sims 4

Even before this recent base game update, The Sims 4 has several trans- and nonbinary-inclusive options when creating a Sim. You choose an overall Male/Female option, but then you can also choose a Physical Frame of Masculine/Feminine and apply any clothing choices you wish. I could critique the Male/Female only options (no nonbinary or intersex option) but, I feel this is fairly good and inclusive for a mainstream game.

The dropdown menu on the character creation screen showing more options for gender: Physical frame: masculine or feminine. Clothing preference: masculine or feminine. This Sim will be able to: Become pregnant, Get others pregnant, or neither. Can this Sim use the toilet standing? Yes or no.
Screenshot from The Sims 4

You can select your Sim’s Sexual Orientation also. Kudos for separating romantic and sexual attraction — that’s cool! — but again, no specifically nonbinary options. I usually just check all the boxes (attracted to all genders) because bisexual people are awesome!

Dropdown showing sexual orientation options: This Sim is romantically attracted to: Men and/or Women. This Sim is exploring romantically: Yes or no. This Sim is interested in WooHoo with: Men and/or Women.
Screenshot from The Sims 4

You can select your Sim’s pronouns when creating them. These are used occasionally in the game, usually for notifications about your Sim’s job, skills, or other occurrences. “They/them” is the first option, and there’s also an option to enter custom pronouns.

Dropdown showing pronoun options: They/Them, She/Her, He/Him, or Custom Pronouns.
Screenshot from The Sims 4

Queer Representation in The Sims 4

I was thinking about what makes The Sims feel LGBTQ-inclusive. It’s certainly not forced on the player. But for a player who wants to create a queer chosen family in a community with same-sex relationships, all the options are there. The Sims 4 doesn’t have homophobia or transphobia programmed into the game. Sims treat each other similarly regardless of their gender. Simply because gay or trans or women Sims are not discriminated against in the game, it feels like a gender-inclusive utopia.

Screenshot of two Sims in a hot tub.
Screenshot from The Sims 4

I’m delighted to explore these new trans-inclusive options in The Sims 4 base game. Whether or not I end up using them often for my Sims, it makes me feel good that the game developers are making this statement of trans visibility. And now, if you’ll excuse me, I have a dream house to design for my next queer chosen family in The Sims. 🙂


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