Gender and video games have a storied and stormy relationship, and not just in terms of the decades of gatekeeping around turning it into a boys’ club. Although playing as a woman is far from uncommon, and having a choice in your player character’s sex and gender is hardly recent either, the conversation somehow endures. Most consistently outrageous of all is the idea that anyone should ever be exposed to anything outside of the rigid gender binary during their gaming experience, and this remains an extremely divisive issue among exactly the sort of people you would expect it to upset.
So to, uh, ‘celebrate’ the trans community’s extremely troubled relationship with representation in gaming, I thought we could have some fun rating ways to Trans Your Gender in games over the years. For no particular reason, I personally find this topic interesting.
Here are the rules for inclusion:
The change is made to an existing character, rather than occurring as an option during character creation (even when those options include being transgender and/or nonbinary in some way)
The change is implemented diegetically, rather than through game abstractions such as the character creator. For example, your character uses an item, has an interaction with a character, or otherwise does something in the game world that results in a change to their physical sex or gender identity, as opposed to the player airlifting them into a game menu without any particular in-story context.
This is also gonna be a pretty short list - not because there’s very few examples (there’s more than I’d have expected, really) but because it’ll get boring otherwise.
So let’s have a look shall we?
Gender Swap Coffin - Dark Souls II
This one’s actually pretty great. I’ll let an anonymous commenter on the Dark Souls 2 wiki explain:

I’m not the biggest fan of Dark Souls II specifically, but I have to say they kinda knocked this one out of the park. Instant, painless transition elegantly expressed through the metaphor of death and resurrection: it’s almost Biblical. It’s definitely desirable.
The only problem is the coffin doesn’t actually tell you what it does before you get in. I mean, sure, why would it, it’s a magic coffin, it doesn’t owe you anything. But that’s not informed consent - that’s forced transition, and that’s not cool, magic coffin!
Rating: 8/10
Potion of Transmogrification - Fable II
This kind of sucks honestly. It’s gatekept behind some crypt-trawling only accessible at the end of the game after you buy a fuck-off massive property, and while there’s a point to be made around the prohibitive expense of physical transition, it’s never actually related to land ownership as far as I’m aware. Your spouse will no longer be attracted to you after you use it unless they’re bisexual, but bisexuality hasn’t reliably or automatically helped that problem in my experience. Also if you refuse to use it the moment you get it, it’ll just disintegrate for no reason, and HRT drugs don’t expire that fast or I’d be a lot more urgent about my daily phone reminders.
Plus it’s a fucking dick bottle. Fable is a crude game with a crude sense of humour, but I’m not giving it a pass for that. It’s a dick bottle. The gold value of the potion is ‘6969’, which doesn’t even make any sense. That’s a sex thing. I’m only giving it any points because using it retcons every reference to your gender in the entire world including pronouns in your dead sister’s diary, and that’s based.
Rating: 3/10
Reversal Ring - Dark Souls III
So - okay, technically this doesn’t alter your character physically. But we’re not transmeds here are we, it doesn’t have to. What this ring does is change the animations for your character from the male set to the female set or vice versa.
Where this item really stands out is that it confirms Dark Sun Gwyndolin - sorry, trans goddess Gwyndolin - is transgender. Basically enshrines it in canon, and that fucking rules. Here’s the item text:
A divine ring granted to the Darkmoon Gwyndolin in his youth.
Causes males to perform female actions, and vice-versa.
Gwyndolin was raised like a daughter through the aura of the moon, and was said to behave like a sullen brooding goddess.
Yeah, I bet ‘he’ hid eyeliner under the bed and cried at the end of Rocky Horror as well.
With Gwyndolin’s ring, the Ashen One too can have that strangely painful epiphany that serves as the turnstile between our old life and our true one. And it teaches you how to modify your gait, which is nice, that saves some time.
The only problem is you kind of have to go looking for it, and these things generally tend to find you.
Rating: 7/10
Mr. Mackey the School Counsellor - South Park: The Fractured But Whole
Hmm. Why is South Park in here. I must have done that by accident.
No, hang on, this was genuinely really good.
In The Stick of Truth - the game before this one - your character is male. Or let’s say Presumed To Be Male, for reasons that will become clear. I actually did not know this during character creation, and made a girl as I am wont to do, and then was slapped in the face with a ‘he’ from my very own in-game parents! Fuck! Talk about truth in fiction.
Your character is basically mute throughout the whole game so I was going about getting misgendered by the population of South Park the entire time, which is hardly unexpected really. But then, in the sequel, something magical happens.
You see, The Fractured But Whole has you play as the exact same character from the first game. You can completely scramble your appearance, but it’s canonically the same person, references will be made to your inclusion in prior events, etc. Early in the game, during a quest called ‘The Talk’, you’re told to go and “confirm your gender” with the school counsellor. I guess that’s maybe overstepping the line for the role of pastoral staff, but fine.
And when you do, this happens.
I shitteth thee none, this is the most I’ve ever seen a game do for being trans within the story space. In fucking South Park. Somewhere, a finger on a monkey paw surely curled.
This interaction, in which I clarified that my character was a trans girl, utterly transformed the strange experience I’d had in the first game. Now, being misgendered about town while I was aborting alien bombs and shit was part of my story. And of course, characters thereafter referred to me accordingly, which I appreciated because it’d be pushing it a bit too grim otherwise. I also got attacked by some transphobes outside the school immediately after this, but since I got to beat the shit out of them I can live with that. (They come after you whatever you pick by the way, it’s part of the joke).
The issue is that, true to South Park’s ‘never be sincere for a moment’ approach, they arguably veer towards making fun of what they’ve otherwise done a good job of later. A return to the conversation plays out like a flowchart of questions resulting in an increasingly nuanced gender identity (and an increasingly flumoxed Mr. Mackey) and whilst there’s really nothing wrong with that on the face of it, it’s hard not to see it as just another thing the game is making fun of.
That said, based on comments and reactions I’ve seen around this, it does seem like even this section is broadly well-received and not taken as mean-spirited at all! So maybe I’m just an oversensitive wokie.
Either way, full marks for the routine, but I don’t feel like we stuck the landing.
Rating: 9/10
Phial of Fantasia - Final Fantasy XIV
I haven’t played Final Fantasy 14, but there doesn’t seem to be that much to know about this one anyway. Drink a potion, and change your character’s whole appearance (and gender if you’re so inclined) the next time you login. Simple enough. I guess maybe a bit too simple, and circles around to that notion of just dropping you into the character creator rather than reckoning with it within the story space.
The real problem is, while this is a paid item and I guess that’s technically realistic, you do get one for free and that definitely isn’t. Some rando just gives you it, no less. It’s like the myth of people putting drugs in Halloween sweets, it just doesn’t happen and if it did I’d be first in line.
About the potion. Not the drugs. I don’t do anything illegal not ever no sir.
Rating: 6/10
The Sex Hex - Flipwitch: Forbidden Sex Hex
I HAVEN’T PLAYED THIS I SWEAR TO GOD.
Rating: 10/10