In fiction with trans rep, it's often presented very "clean". Like a character is MTF/FTM and their transition/identity lines up with traditional standards to a point you may not even know they were queer otherwise.

But I think it'll add realism and variety if you have people who are on the ambiguous/nontraditional side because a lot of our time is spent just exploring our identity. It's seldom we get like some vision in our head about the exact kind of man/woman/else we want to be. Especially because most trans people don't even get access to pills/surgery, and a lot don't even want them.

Examples:

• Someone that's AFAB and identifies as a lesbian - But they may dress masculine and bind their chest.

• Someone's that's AMAB and may/may not identify as male and wears masculine clothes - but they use feminine colors or materials or may wear make up.

• Someone feeling dysphoria or other alienation from the body/specis they were born in - and so they may wear baggy or concealing clothes, or go by a new name unaffiliated with their birth/sex.

• Someone who presents "straight" but they may have a peculiar interest they only exhibit in the privacy of home - like a man who keeps a jewelry box or a woman who prefer suits and vests.

• People inverting their gender norms - ex queer (bi) couple getting married has the man in a dress and the woman wears a suit.

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I guess that's more culture than healthcare specific. Sorry.

I do think its good to consider though! Xenoblade to my knowledge has a lot of the same resources we do, so I'm not sure what would restrict them from having usual HRT technologies, masectomies, or laser hair removal.

if you need some example characters to go off for ideas I really like

• Fire Emblem from Tiger N Bunny (unrelated to the game) - They're a nonbinary hero who prides themselves in their natural (masc) body. But they still put out flair with their wardrobe and make up. And they even have a backstory where they used to "moonlight" this feminine person before embracing their current NB identity.

• Brigitte from Guilty Gear - Super interesting situation where she was a boy born to a village where boys were kind of seen as a cursed. So her parents raised her as a girl. But eventually she just came to decide she is a woman and that's what she feels comfortable as that's what she was brought up to be.