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.”
Pocali culture doesn’t assign any specific societal roles or presentations or clothing to you based on whatever body parts you happen to have been born with, or whatever body parts you happen to have right at this moment. People dress how they want, perform the work that best suits them, and adopt whatever mannerisms feel comfortable to them.
As such, there’s no Pocali word for “transgender.” Everyone uses neutral pronouns, and there are no opposite sides to “cross” over to. But there are still people who experience body dysphoria, given that this is a condition separate from gender identity.
Pocali medical science offers a few avenues of relief for folks with body dysphoria, the most common being hormone treatments. People who seek these treatments are known as peliyn, which literally translates to “one who changes the body.”
The Peliyn Medical Society is a group of doctors, pharmacists, and scientists who are knowledgeable about the effectiveness and limitations of currently available treatments, and who take an interest in researching new options.