With “Dys4ia,” however, Anthropy took her confessional impulse to a new level. In the game, which lasts less than 10 minutes and uses simple Atari-style graphics, the player proceeds through four levels (Gender Bullshit, Medical Bullshit, Hormonal Bullshit, and It Gets Better?) that reflect the challenges of deciding to undergo estrogen replacement.
“I feel like spy whenever I use the women’s bathroom,” reads a strip of text near the start. In the second level, the protagonist locates a medical clinic, where a doctor demands that she reduce her blood pressure before treating her. In the third level, she begins taking estradiol, and finds herself crying at everything her girlfriend says.
But things brighten near the end. The final screen shows a steadily rising sun with the words: “It’s a small thing but I feel like I’ve taken the first step toward something TREMENDOUS.” The bare-bones design, combined with the unself-conscious directness of the story, gives the game an unexpected emotional power.