I like you described example ...
But just as you, im probably also blind to some aspects that may be problematic. :-/

So far the only character i know in games, that was trans and it had significance for story, was Krem from Dragon Age: Inquisition:
- Born as a female
> wanted to be a Warrior, and was good at it
> joined Qun (not sure if before or after)
> in Qun only males can be warriors
> so by their definition Krem was a male
And was happy that way. smile

I still dont understand why cant we change Race for our hirelings. frown
Lets us play Githyanki as racist as they trully are! frown