It's a management sim/tycoon/build a thing game (a bit like RollerCoaster Tycoon or Theme Hospital?) wherein you try and set up a medical/chemical compound producing hormones and providing surgery for the trans people of the post-apocalyptic world.

(and there's all sorts of post-apocalypses to choose from, from Fallout-style bleakery to peaceful nature ruins land. All with their own problems.)