Gayming in 2024
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Transgenders, like disabilities, should literally never exist anywhere in Fantasy.
If you have the magical power to levitate, then you have no explanation why you would need a wheel chair beyond a curse planted by a deity.
A transgender would have the same problem. You would just use magic to literally become the other sex. You don't need to "live your life as the opposite sex", you just literally work to become it through magic spells, even if you have to purchase a potion.
Again, the only exception to this would be as a curse to live your life wrong, so that no magic can heal you.
What I'm saying is that fantasy only allows for cripples and trannys because they are cursed by the gods.
Depends on the power/availability of magic honestly.
Say in PF (1E) regenerate is a 7th level spell (for clerics) so you caster needs to be at least level 13. Cost of service for spells is: CL x SL x 10gp = 910gp
A trained hireling (scribe, mason, ...) costs 0.3 gp / day. So - even ignoring availability rules - it's reasonable to assume that cripples exist in the world. For NPCs.
Cause PF has a "wealth by level" stat which is a rough suggestion how rich (in magical items) characters should be. PCs at level 2 are already at 1000gp. There's no reason to not regrow your lost leg at that level.