It's very interesting to me how midst/unend treats different types of queerness.
Being Bi or Gay is seen as normal, as far as we've seen. But because gender is still very prominently a thing in the midst/unend universe, transness is still a thing and a complex one at that.
The first time we've seen it mentioned (as far as I remember) is in the most recent episode, where Everett comes out to Dot. There's no tension over whether Dot will accept her or if they'll attack her, which indicates to me that there isn't really hostility against trans people in this universe.
This is interesting, because it would indicate that the problem with hostility to queerness that exists in our world doesn't exist in the unend universe. However, being trans is still portrayed as a difficult journey.
The manner of Everett's confession is also portrayed as something unexpected in the way its narrated, which could be a deliberate subversion of the audience's assumptions, or it could mean that transness is not common in the unend universe.
Whereas with same sex relationships, this is something that doesn't even require an identity. Fineas and Jonah, Everett and Mickey, in no capacity do either of these pairings seem to present any deviation from the norms of the unend universe.
Transness is a deviation.
But, again, because the stigma around transness is nonexistent, the struggles of it become more internal and relational. Being trans is still portrayed as a long, difficult journey. There's isn't magic instant estrogen pill that instantly makes you be able to feel comfortable in your gender, and Everett expresses that even after transitioning for at least 15 years, she still feels unsure about herself and her identity.
She also expresses that at the beginning of her transition, she thought other people were suffering more than her, so she wasn't going to pursue any transition, because it would've put more strain on the people around her, or because she felt others would do better with the help and resources she would be requesting. Which as a trans person, is a very relatable feeling to me. She views being trans as something that could put strain on relationships or medical systems unnecessarily.
In a world where transness is accepted, but transitioning still requires medical and therapeutic care, there is still an internalised feeling of worthlessness or not taking yourself seriously or not believing that your problem is big enough to require resources.