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Notes -
I think you raise an important point about frontier spirit, which I consider one of the problems we are facing, that modern life in many ways is ill-fitted to our nature.
I think you might want to think a bit more carefully about what kind of people we send on missions though. I think modified humans that have been engineered for cooperative behaviour might be a safer bet than 'wild-west' types. I don't know if you are familiar with the mutiny on the bounty tale at all, though to their credit the colony survived even if everyone is now related to Christian Fletcher...
As to medical improvements, I'm for them- I could be persuaded of a reasonable amount in this domain. Cosmetic procedures I would endure if there's a good reason, an unsightly mole but not really anything at the next level. I'm in the norms of feature proportions as far as I can tell so haven't had the need. I seem to get uglier year on year but don't notice for large periods of time so it's no biggie. Full-body tattoos are good for Yakuza etc
My concern around the impulse for sex change in some people is part of it may be originating in cultural ideas. I contend it's better perhaps to change the cultural space rather than mainstream cosmetic surgery.
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