Sims from The Sims 4 who have had their gender customized in Create a Sim. This can include their pronouns, physical frame, clothing preference, pregnancy settings or toilet use.

Sims in this category should not be added to the LGBT Sims category unless they are confirmed to be LGBTQ+ by the game's developers, they have a customized sexual orientation, or they have customized pronouns.

To add an article or category to this category, append [[Category:Sims with gender customization]] to the end of that page.