I think this game would be more wholesome if there were two clear paths for sissy and trans. Or you can just ignore the trans path if you really don't like it.
The reason for the above comment is that I feel it is a bit wrong when DR Mifune still calls MC sissy after the following choices: A woman -> Be myself -> It feels right -> To be the girl...
I used to identify myself as a sissy for many years. Later, when I was brave enough and knew myself better, I accepted myself as a trans woman.
I know all sissies are different, some finally accept themselves as a "full-time woman", and some decide to be sissy for the rest of their lives, there's nothing wrong or right here. It's just the way people, and especially a psychiatrist like DR Mifune, keep calling MC sissy after the choices I mentioned above that makes me feel like trans women have been erased, even though I believe you don't mean it.