One thing they never really get into in Star Trek is how the body modification scene evolved in a future with medical replicators and “Doc will shine a light on it” levels of medical technology. I’m sure they could easily perform a gender transition, including changing reproductive organs to whatever combo a person wanted, in an afternoon, to say nothing of the possibility of cosmetic and functional structural changes. We see them perform highly complex and detailed biological modifications so crew members can pass as aliens like it’s nothing, so why not make people taller/shorter, wider/narrower hips, bigger/smaller boobs, more feminine/masculine face, horns, pointed or alien ears, new sense organs, extra arms, etc. What kind of wild piercings are people getting? What new methods and styles of tattoos have they come up with? The possibilities are incredible. That would be a fun world to explore, even within the Federation’s taboo against genetic alteration.