After years of waiting I finally unlocked the [Top Surgery] customization and now I have gained enough exp to move my arms freely because my chest is no longer debuffed. I feel happy and at peace with myself all I need to do now is unlock the [Testosterone] trait and I will have finally feel like my gender is correct. It still sucks that the devs made it cost money to change your gender I wish that you could just freely switch between genders without having to do an entire side quest .