Riley is a surgeon. They intend to be the best surgeon.
Work in progress...
[the loss or pull that Riley felt was wanting to actually get what they were promised (impliedly) from the medical program(s), to be a doctor, with all the privileges and prestige that are supposed to accompany it. The potential that comes with graduation, the future that finishing medical school unlocks, was the loss, and that promised lifestyle was the draw that helped them find their way back.
They're also challenged by a tendency to view those classed as "patients" as more objects than people, which is a loss observable from the outside, but which they are not so acutely in touch with. And because of the medical experimentations that were conducted on them, they are actually lacking any clearly-identifiable physical manifestations of biologicial sex. They don't really remember what parts they had before, and have no strong connection to gender as a concept that might guide the identification of a particular gender pronoun. I'd class them more as transhuman than transgendered, because it's more of a perspective of sex/gender not mattering (and being medically/magically mutable when you're in Arcadia) than of actively identifying as non-binary, but I'm using they/them pronouns because I'm actually out-of-character not sure what gender pronouns to use. Riley doesn't care, and as long as it's clear from context that someone is talking about them, they would respond to any pronoun someone chose.]