OK, I'll be the first to say that I do not know everything about genders, but based on the premise of the game, the message that I see here is how far humanity can go to alter their nature. Its more of an exageration of today's culture. Today people who want to change their sex or gender goes great lengths to do so. Men have to go surgeries and after that they have to stay on medications if they want to stay on a female gender. The way I see it is that the in game ad as an exageration of today's culture.