Surely there’s no cause for concern, though. See for yourself:
I’m sure I’ve talked about this before, but to recap: the Pocalo Valley is widely renowned for its advanced medical treatments for all sorts of conditions, including trans medicine. When Razi references hormone treatments, that’s what xe’s talking about.
Also, the last panel is referencing the Valley of the Silk Sky short story “Medicine; Run,” though you don’t need to have read it to follow the events in “Extraction.”