Standard company feminizes you. You can edit the html/sugarcube to start female, but it's buggy. Mostly text-based, which I tend to prefer since it usually enables more customizations/options. There were some character portraits, sprites, and chapter header art, but not much else (though that may be due to me having filters or non-applicable characters). You can choose NPC character's pronouns but not their sex/genitals.
Speaking of bugs, the routes feel very spaghetti-tangled in that you'll frequently get stat locked by some event that may take hours to trigger so you can never proceed. The TSF focus also gets in the way of continuity where you can already be missing a penis, but you'll randomly have it for scenes, or come to terms multiple times with feminization because there are so many scattered flags/triggers that don't get picked up. Because most of the game involves internal rationalization/acceptance of the feminization, it'll be reiterated in various story branches feeling kind of redundant, but it may have stood out more to me since I try to avoid the MtF parts.
There's also a heavy focus on anal stretching which is def not for me. I get my hopes up when I see there's a female protagonist game that involves mental/physical alteration, but they always seem to be based around sissification, prostitution, and getting passed around which are turnoffs for me, so my low rating may include some of that exasperation. YMMV.
TL;DR there's a lot of content/scenarios for the text-based TSF genre, but locks and waiting on grind/rng for flags gets old.