lore-friendly transitioning methods

[Cleretic]

Since the game focuses on heroic adventures and not gender identity drama, however, it is not really elaborated on in-universe.

Yeah, this is fundamentally an element of storytelling focus; trans stories just don't intersect enough with the game's focuses on Big Action and character drama for stuff like 'medical science intricacies' to really turn up in the story except as an implication from some side-deal. The plastic surgery I mentioned was from a story beat largely about espionage, and glamors and transmogrification only get used to that degree in a few fight mechanics and, like, one 2.x quest about the sylphs that I think got cut. You'd think Alchemist would be the best suspect for related lore on this, but its storylines instead ended up focusing on, like, forensics (which is fair, forensics is a cool place to take alchemy). As a result there just isn't clear info on this.

The only times when the game's stories have linked up with transness are debatably Sadu and Mitron, and even more debatably the 'gender is complicated and/or unimportant' figures like the pixies, Omega, or the dragons. In all of those cases, transitioning, be it medically or socially, isn't part of the story being told, and their gender situation is just an extra piece to who they are. I personally find that disappointing in the game's totality--I think the game could do it and would do it well--but individually all makes complete sense; Sadu and Azdaja do not need that element to their stories even if I would like if they had it.