Quote Originally Posted by Anymage View Post
Death can be solved by a fifth level spell that the party can just pick up at ninth level. Hat of Disguise only costs about 500 gold in 5e, and under 2k in 3.5. And if we're looking at 3.5, any cheap magic item can be made with the "curse" that it switches the wearer's sex while held*. With the sort of magic that D&D worlds expect, transitioning should be achievable rather early into the character's career.

Which kinda goes back to what I said before. If you want to explore the day-to-day life of a person living in whatever sort of situation, you're going to want something aimed at that scope. When you're the person they call on to put down ancient dragons and eldrich abominations, little things like society's attitudes or the birth configuration of your body stopped being meaningful long ago.
If you treat it as just another character detail like eye color, yes, then it should be. I was personally more focusing on when being trans is a central and integral part of a characters story and development. I disagree that just because you hunt down dragons things like that become irrelevant. After all, I'm playing a character, not a statblock.