okay i bit the bullet & got it (its 10% off until June 1) & yeah i think they've done a pretty good job!
you can select gender (male / female / nonbinary, only one) but it is not related to any physical traits; you can look any way and be any gender. the gender selection also includes
pronoun selection (he/him, she/her, they/them, only one set)
ability to be pregnant, impregnate others, or neither
the ability to breastfeed or not
you can have breasts, an Adam's apple, facial and body hair, a higher or lower voice (there are 4 options rn), and none of the clothing, hairstyles, or decoration is gendered either. there's no top (or bottom) surgery scars rn, but i believe they are planning to add binders that actually function to flatten a character's chest in the future too, and on steam there's already a lot of folks working on mods so i'm sure there will be plenty of options going forward both from user content and the base game.
also, you can make fat people! there is a body fat slider, but also a lot of customization across the body, so you can have characters that are fat in various different ways. they've also got a hijab and turban option, and options for prosthetic legs, hearing aids, and a face mask. in terms of non-white people, they've got a good selection of curly hairstyles, you can have any type of nose, and you can choose custom colors for the skintones (and pretty much everything else) and you can change the palm skin color specifically. they've also got pride flags in build mode :) trans, progress flag, lesbian flag, pan flag, and ace flag right now.
its still in early access so its not flawless, but they've also said all updates will be free and part of the base game, and are working on fixing bugs and adding more content. so if you like the Sims-type games, consider checking it out!