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Also lets imagine it even existed, just like super cars exist in our world, that does not mean everyone has access to it, same as most people can't afford a super car and in some places you can't even find them.
Not even in hogwarts legacy, with insano level magic, a trans character could fully transit into being another sex, so it's no surprise they can't do that in dragon age either.
Now thats me explaining ♥♥♥♥ with logic and lore in mind, which is more than what these devs did when writing this game. So while my answer is grounded in the world of dragon age, their reason for having it the way it is likely just blatant self inserts and a political message.
But yet, the people of the Dragon Age universe apparently HAVE somehow managed to master the art of gender affirming surgery and hormone replacement therapy.
So, then why do they have mastectomy scars? If it's magic then why would it leave scars?
It was handled in a far less preachy and hamfisted way. Krem was also a super minor character.
As for whether such a potion exists, so far as I am aware, no, not in Thedas.
There's shapechanging magic, but the only kind that I know of that lasts was curse and was cast by a spirit/demon.
Mages can do temporary spells on themselves. So if you're trans and a mage, you've got yourself covered if you study the right branch of magic.
Of course, you can't choose to be a mage, and mages are kind of rare. And in all previous games we've seen, they're kind of locked up in concentration camps so not exactly easy to contact one and get them to help you make a deal with a demon for permanent changes.
ETA: Saying they'd still be trans is overly simplified since different groups through history have gone about accepting what we would think of as trans people in their cultures. They would still be people who were born with one biological sex and felt they should perform as a different gender.
For example:
The elven god magically switches your gender, and your personal quest becomes coming back to your form.
Meanwhile, you can experience all the associated hardships of being trapped in the wrong body, like being hit on your by your fellow companions of the opposite gender.
At the same time, there should be some good moments like you joining a gender restricted tournament where only women are allowed. You easily beat every one and win a trophy and everyone's recognition and acknowledgement. At the end when you find a way to break the curse, you can make your decision whether to return to form or stay with your new found self.
EA send me money.
How has the medieval society developed trans gender affirming surgery? From a lore perspective, that's just immersion breakingly out of place.
Equally, how have they developed not only advanced hormone replacement surgery to allow people who have undergone a double mastectomy to look like dudes but also the distribution system to allow people to have a regular supply?
This sort of thing works in a Cyberpunk universe but not at all in a medieval adjacent fantasy universe.
I be honest, I am pretty fair person, which is why this whole preaching is pretty annoying. I treat everyone the same when I meet them and my opinion changes based on their own actions. So whole inclusivity push thats been happening is annoying cause to me it's anti equality. It's more glorification and trying to stand out and to me highlights a large problem where people do not wanna be equal, they want to be above others, which is why people wanna get rich, famous, etc, it's in our nature. So people enjoy tons of special privileges and they do not want it to stop.
I am also well aware that people that say that "well hurhur, there been gay and black characters in games before!" which is like yeah, and in movies but lets be real here, majority are white and straight. There needs to be variety but it should be organic, like bill in the last of us (the game, not show) or jesus in the walking dead. They were characters first and being gay was just part of who they were, no their entire identity that they had to champion as first thing about them.
On flip side everyone garners their own culture, which is why there are also so many black only or primarily black circles, be it rap, way of life, sororities, etc. I know that might sound stereotypical but these are my real life experiences and if you got anyone to blame for these stereotypes, it aint me, it's people that cultivate them. So it does feel a bit annoying when culture thats been basically made by people like me, white and straight, starts to get highjacked by basically guests and turned upside down. I say guests not cause they might not be white or straight, but because they clearly do not get the source material, changing it to be loud and political.
That being said, finally to my question and point. Trans people really do not fall into same circle in my opinion. I am no educated on trans circles and such, if there even is such a thing, I do imagine you guys/gals are basically just like anyone else, and being trans is not like white or black or hispanic culture but more sex/gender oriented, which anyone can be either basically. So trans people been really unrepresented in games and movies for long while. So that never bothered you or did you never felt some sort of identity connection when such character finally came along?
Sorry if any of this came off rude, it's not meant to be.
Fantasy worlds have their own lore and things still need to fit the setting. It's not just "LMAO, ANYTHING RANDOM CAN HAPPEN!"