So, I've had this idea floating in my head for some time now. I've been nervous about letting it out because it may go horribly wrong. One of the worlds I set my fiction in is high magic in the modern world, and I've been asked how trans people fit into that world several times in chats and casual conversation. My response has always been, "perfectly, because that's how they should fit any world". But it certainly ignores the basic mechanics of it.

How would magical transition look? What would it entail? What's the history of it, and how does that history influence the broader world building. To me, building a magical world where trans people didn't exist wasn't realistic. Building one where they were limited to real world processes was too realistic. What's the balance? Where's the line? And can I, a cis-hetero male writer, speak to the subject in a respectful and caring way?

That last one is the hard part. I never, ever want to write something that hurts. I know that's a risk with this kind of subject matter, and I so deeply hope I didn't fuck this up. If I did, I ask forgiveness and room to improve myself.

---

The Appointment

"Please, do come in Ms Dixon."

I could see she was nervous. So many of my clients are. It's a scary thing, transformation. The early days, when magic first came back with a bang, mistakes were made. The fluctuations in the magical field didn't help, but the lack of deep knowledge of how to use it was the real problem. Everything was either an experiment, or trying to replicate ancient texts. There were no direct rituals or spells for radical transformation of the body permanently.

That kind of power was for the gods, not we mortals. Sure, if you wanted to run as a wolf for a night, or maybe a bear, chances were good you could find something to build on, if not something directly for that. And surface level alterations were easy enough. It was deep change that was elusive and dangerous. It turned out that shifting cells that are actively replicating and repairing themselves, well, magically interfering with that process was bad if you weren't an expert. No experts existed.

Lucky for he field of Healing, some examples of the wider world of magic brought us help. The vampires and were-creatures, the various fey entities that could fluidly move between states gave us something to study. By the time the god wars kicked off, Healing as a field of magic was coming along. Unfortunately, a world spanning devastation at apocalyptic scale kind of inhibited development of specialities that weren't trauma and surgical in nature.

But there were early attempts. The need was high enough for people stuck in the wrong bodies that they would often chase any rumor, take any risk to find relief, to inhabit a body that fit.

Hence the visit from Ms Dixon. She had been one of the earlier brave souls willing to work with Transformative Healing researchers. It was all done rigorously, but outside of oversight or supervision by any governing agency. There weren't governing agencies. Boundaries were pushed. Too far, too fast, too often. Some of those brave souls died as a result of experiments. The less fortunate ones wished they had, with some taking their own lives before knowledge reached the point to be able to help them. Because what changes happened were often unbearable.

Ms Dixon, she was a success in many ways. From the outside, fully clothed, no one would know she had not started life in a body like that. But there was much pain as the cells of her organs fought each other. There was pain with her digestive and excretory function, as much of that work was primitive and poorly executed by modern standards. In all truth, conventional, non magical medicine was far better at that time. At least there, results were predictable. Surgery never made anyone grow gills and suffocate before they could be moved to water.

But it had taken over fourty years before magical capability reached the point of being able to put right what went wrong for her. She had to watch as others, starting after the experiments and mistakes, benefited from her pain in being able to make the transition younger, with little or no complications. But we finally did it. We finally got there, and I'm one of three healers in the world that can do it all.

Her face, the tension in her shoulders, I was taking too long thinking.

"Ms Dixon, I can help. I can finish the job you started in the eighties, and do it right."

"That's... That's not what I expected to hear."

"I'm sorry for that. You should have had this available long ago. If it weren't for you, a lot of it wouldn't be possible. The procedures you volunteered for, the examinations and scans you've allowed got a lot of people here before you. I'm grateful to be the one that gets to return the fruit of that to you."

"I didn't start out doing it for anyone. I just couldn't not try. And when new things came out, I had to keep trying, until nobody could do more because of the things already done. That's when it started being less about me."

"In any case, ma'am, my entire sub-speciality was built on your shoulders as much as any practitioner you worked with."

"You really can do something for me?"

"Not just something, a full transition. Organ rebuilds, cellular repair, gene editing; all of it. The last scan we did? That was partially me comparing your current genetic fluctuations with the cell cultures you gave us that I had been working with. I'm going to be able to stabilize it, and stabilize the XY in particular. No more rejection meds, no more stasis spells. Once we're finished, you'll be as fully transformed as any of my younger clients that started from scratch."

"How long?"

"That's the less exciting part. A year, maybe two. We have to start with the hard parts and let it propagate before we can grow new organs. Gene editing via magic is a slow process any time. We have to be twice as slow with you because of the primitive mistakes made that keep you in flux. It was the best they could do then, but it's very resistant to repair and stabilization. That will take half of the first year for sure. Longer if your spirit struggles to resist the shift. It shouldn't, it's a very rare thing for someone of a misplaced spirit to resist, but it does happen since our spirit is so woven into our flesh. Habits can build up."

"Oh. I thought it might be longer. A year? Two. Oh.

Will it hurt much?"

"Some, yes. Not the initial part, the gene editing I do feels warm and tingly. Perhaps as potent as a TENS unit at low settings. It's diffuse. It's the organ growth that hurts. You can't make a uterus grow without it displacing other things, and you'll experience the entirety of that growth rapidly. A month, perhaps two. From the seed cells to a pubescent organ in that time frame, alongside the ovarian transformation so we get the timing right, you do the puberty speed run much, much faster than someone transitioning over the span of a normal puberty would. That happens over years instead, so it's not much different from the pains of puberty alone.

You, however, can expect severe cramps, aching and throbbing. I can adjust some things, and we have meds to dull it, but we can't eliminate the pain entirely. The vaginal restructuring will be roughly as painful.

The breast tissue will be easy though. While we have to excise what's there as well as the implants and get rid of scarring, the pain is minimal. Akin to tender breasts during menstruation or pregnancy."

"Puberty. Real puberty."

"Accelerated by necessity, but yes. As real as it gets."

"It's a shame though. That it came so late."

"Very much so. We, we Healers, should have made this a higher priority. But it's such a complex sub-specialty and takes a certain mandatory range of ability as well as capacity."

"I meant that it's too late to use it all. The uterus. Why is your work so limited? Why did it take this long?"

"Too late? By no means, Ms Dixon. Yes, any pregnancy would be high risk, if that's what you mean?" She nodded. "Your body is in its late sixties, true. And that comes with difficulties regarding pregnancy. But your reproductive system, the ovaries, uterus, vagina, everything is going to be essentially brand new. When it's all finished, your reproductive organs will be the equivalent of a late teens or early twenties woman, for a while."

"How long is a while?"

"There, I can't be specific. It's too new of a process. But equivalent work done with recovery after the ovaries, fallopian tubes, and uterus were gone for some reason; has given women as much as a decade of function even when the regrowth happened at your age. I suspect that the gene editing will have some effect on that. It may be less, it may even be more. We can't rejuvenate, not yet, but your cells will have a bit of extra oomph for few years, for lack of a better description.

But you would want to wait a year or two after everything is finished before attempting pregnancy. The work I'll be doing is safe, but there's never a zero risk situation, and we are altering genes. They need to be fully stable before trying to make a baby. Only way to be sure they are is time."

"Oh. I can't see myself trying to parent in my seventies."

"That's up to you. But if you decide otherwise, please do let me know so we can take every precaution."

"You didn't answer me about why it took so long. Why now?"

"Well, the specialty got a late start for one, which you already knew. But it's hard Ms Dixon. Standard Transformative Healing is hard enough. Replacing limbs, growing them when they weren't there to begin with, even cosmetics, it takes a lot of energy. Just a facelift can take a tenth of your wellsource, if you have a deep one to begin with. Some healing, all you're doing is a trickle to push the person's body into healing itself. Something like trauma healing can take it out of you because there's so much to do, but each individual step is low energy.

But gene editing? Generating stem cells and programming them? It's all on the caster. Even cosmetics, most of it comes from the caster because you're changing the body away from its pattern, so the spirit isn't going to help much at all, and there's only so much it can do, unless the person has training too.

Your case is even harder. You've already been transformed, multiple times, and some of that was with magic that wasn't right for the job. The early attempts to change testicles into ovaries were just wrong. Which means that I'm, that any healer, is going to be fighting another magician's work as well as the normal resistat of cells and genes.

That, ma'am, is why it took so long. For any of us to develop that kind of skill meant baby steps, usually transferred from some other discipline, and only able to be developed by the absolute most powerful of us. Right now, there's three people including me that have the strength to do each stage of the work in one go. The first gene edits, and controlling how they spread, will fully drain me. It'll take a few days to recover, and that's a big thing in itself. Most stuff, you refill once you sleep properly. This, if it went wrong, could burn a practitioner out permanently."

Her face blanched, and she started to rise.

"No, no it won't happen, but that's why only the absolute strongest can do it, and why the chain of research took decades. We could only do the research when we weren't treating patients, and that only after schooling and apprenticeship. Most of the best work was from people that could only do maybe one or two days of work on it a year.

My wellsource is why I was first recruited by Master Halligan. He couldn't quite finish his final experiments because he lacked the capacity to make it happen. That I had a personal stake in it was a happy accident."

"A personal stake?"

"My mom was Cheryl Kitteridge."

"Oh. Oh wow! You're the first baby!"

"That's me. The first baby born to a magically transitioned woman. You are her hero, Ms Dixon. Mine too. I wouldn't be here if you hadn't taken the risks you took. I grew up with that picture of you on the cover of People framed in our living room."