Minimally invasive cosmetic procedures are increasing in popularity and demand. These techniques can be used for transformative effects in gender affirmation, yielding unique opportunities to provide care for transgender and other gender-nonconforming individuals. Neuromodulators, such as botulinum toxin, can be injected to alter the shape of the brow or contour the jawline to impart a more masculine or feminine appearance of the face. Soft tissue fillers, such as hyaluronic acid, poly-L-lactic acid, or calcium hydroxylapatite fillers, may be used to alter forehead projection, zygomatic arch, jawline angle, laryngeal prominence, lip fullness, and chin projection. Methods of depilation, such as laser hair removal or electrolysis, may be used to remove unwanted hair from the bearded area or neck as well as to prepare genital or donor skin for phalloplasty or vaginoplasty. In this chapter, we focus on minimally invasive, nonsurgical treatments for gender affirmation. These techniques may be used as an alternative option for patients not ready for surgery or for patients who are poor surgical candidates. They also serve as possible adjuncts to surgery. We review potential complications and pitfalls that may arise when performing these procedures.