You have difficulty having biological children, impregnating someone, getting pregnant, or staying pregnant to term. While this rarely has a role in most games, the GM and player should carefully discuss its role in the game with each other and with other players, making use of safety tools such as Lines & Veils. While this is true of every trait in the game, the likelihood of adult players being affected personally by this trait and the relative trauma associated with it is extremely high. While fertility rates will vary by ancestry, the likelihood decreases by (IE) × 25 percent.

Real-world Examples

Miscarriage, Stillbirth, Diabetes, Celiac Disease, Cushing’s Syndrome, Sickle Cell Anemia, Polycystic Ovary Syndrome, Cystic Fibrosis, Varicocele, Hypogonadism, Endometriosis

Assistive Options

People who would like to have children but cannot due to infertility have introduced a third party to compensate, but this has many potential emotional challenges. Many consider adoption a preferable alternative that, while having its own challenges, also has obvious benefits for the adopted child. Mostly, compassion, not making suggestions, provides the greatest benefit.

Magical Assistance

Legends of magical solutions to infertility abound, but they almost always come at great cost. Hags can assist in this issue, but hags are also known for the tragedy and corruption associated with their assistance.

You possess ambiguous reproductive organs for those associated with your ancestry. This may be expressed as genital underdevelopment or variation, diverse secondary sex characteristics, or presentation of genitalia of multiple sexes. The IE determines how noticeable your ambiguity is in daily interaction as it affects your visible characteristics, and players and GMs should carefully discuss how best to represent this diversity, which may include bonuses or penalties to Charisma (Persuasion) or Charisma (Deception) checks depending on the situation and cultural acceptance. If you have this trait, you may choose Infertility as one of your other traits.

Real-world Examples

Hyperplasia, Agenesis, Gonadal Dysgenesis, Ovotesticular Disorder of Sex Development, Anorchia, Klinefelter Syndrome, Turner Syndrome

Assistive Options

This trait requires no assistance except acceptance of diversity.

Magical Assistance

Magic that affects a person’s appearance, such as a Seeming spell, can affect how you present for the duration.

You need to watch what you eat, when you eat it, and how much you eat to avoid symptoms such as thirst, weight loss, fatigue, blurred vision, or numbness in the hands and feet. Choose or roll on the following table.

Hyperglycemia. If you eat too many carbohydrates in a short amount of time (e.g., a meal with more than a serving of grains, more than one alcohol drink, or more than one sweet food serving), you must succeed on a DC 10 + (IE) Constitution saving throw or become hyperglycemic and add 1d4 of the following experiences until you take a short rest: Nausea, Shortness of Breath, Weakness, Confusion, Body Pain (Abdominal). Roll for IE for each. Failure to take a short rest will increase the IE of each experience every hour and add an additional experience from the list. Once one of the added experiences exceeds IE 4, you enter a Coma.

Hypoglycemia. If you eat too few carbohydrates (you must eat at least a snack every three hours or less) or drink alcohol (yes, it can work either way) you must succeed on a DC 10 + (IE) Constitution saving throw every minute or become hypoglycemic and obtain one of the following traits, cumulative until you succeed on the saving throw: Confusion, Fainting, Agitation, Tremor, or Vertigo, which last until you get a serving of carbohydrates.

Real-world Examples

Diabetes, Polycystic Ovary Syndrome

Assistive Options

Closely monitoring your diet is the key to managing this, and allies who help when asked are invaluable.

Magical Assistance

The Goodberry spell, if used without other foods or drinks except for water, will maintain blood sugar for the duration of the spell.

Even though, according to your age and ancestry, you would typically have physically developed adult characteristics, these characteristics are delayed or absent in you. Whatever the typical age of maturity for your ancestry, it takes you twenty percent × IE longer to develop these characteristics. Until you reach this age, you have advantage on Charisma (Deception) checks to present yourself as a child and disadvantage on Charisma (Intimidation) checks.

Real-world Examples

Constitutional Growth Delay, Celiac Disease, Klinefelter’s Syndrome, Turner Syndrome

Assistive Options

Because this can lead to being infantilized due to being perceived as a child, support and respect from your party helps reinforce to others that they should respect you and treat you as an adult.

Magical Assistance

Magic that affects a person’s appearance and voice, such as a Seeming spell, can assist with this for the duration.

You get annoyed or restless easily, more than is typical, with less provocation than expected for your emotional response. This can lead to difficulty in social settings and relationships. When this feeling surfaces, you must succeed on a DC 8 + (IE) Wisdom (Insight) check to realize that your feelings are an agitation flare-up. On failure, you can make another check every round. Until successful, you have a −(IE) penalty on all Charisma checks except Charisma (Intimidation), with which you have a +(IE) bonus. You also have a +(IE) bonus to saving throws against being charmed.

Real-world Examples

Anxiety, Depression, Bipolar Disorder, Hypothyroidism, Autism, Attention Deficit Hyperactivity Disorder

Assistive Options

Using a short rest for relaxation, breathing exercises, or meditation will stop the episode and prevent another one for at least 1d4 hours after unless faced with significant provocation that would agitate a typical person.

Magical Assistance

The Calm Emotions spell eliminates Agitation for the duration of the spell on a failed saving throw, but you have a +(IE) bonus to the saving throw.

Your muscles in (IE) limbs stiffen, and you have difficulty relaxing them. This trait is triggered by exercise or cold. When affected, your limbs are difficult or impossible to move without extreme pain if at all. You have a −(IE) penalty to any action that would use that limb, including attack rolls. When you take any amount of cold damage or attempt an attack that requires a fast or jarring motion to your muscles, make a Strength or Dexterity (Acrobatics) check, whether successful or not, you must succeed on a DC 8 + (IE) Constitution saving throw or experience stiffening. On failure, the exercise is painful, and you need to succeed on a DC 8 + (IE) Constitution check to fight the pain and continue to hold anything in the affected hands or to avoid falling prone in the case of legs. Walking on a forced march will also require success of a DC 8 + (IE) Constitution saving throw every two hours to avoid the effect. The effect lasts until you take a short rest.

Real-world Examples

Paramyotonia Congenita

Assistive Options

This condition is assisted by avoiding the triggers. You have no trouble casting most spells or firing crossbows (although loading all but hand crossbows is difficult) and ranged weapons, such as blowguns, that don’t require muscle strain or sudden movements.

Magical Assistance

A Potion of Relaxation is effective against Paradoxical Myotonia.

You get hiccups (IE)d4 times per day. You don’t know when to expect them, and they’re painful and last (IE)d10 minutes. (The GM should roll at the beginning of the day and roll or choose random times throughout the upcoming day.) During a bout of hiccups, you must succeed on a DC 10 + (IE) Constitution check to successfully cast a spell with a verbal component. On failure, the spell fails, but the spell slot is not used. Because of the painful distraction, you must also succeed on a DC 8 + (IE) Constitution saving throw to maintain concentration each round on an applicable spell. You also have a −(IE) penalty on Charisma (Persuasion) and Charisma (Intimidation) checks during a bout of hiccups. If a bout of hiccups occurs during a long rest, it will disrupt the benefits of the rest, depending on when the bout starts and how long it lasts.

Real-world Examples

Traumatic Brain Injury, Multiple Sclerosis, Diabetes, Kidney Disease, Anxiety

Assistive Options

Common treatments for hiccups don’t help with chronic hiccups. A successful DC 5 + (IE) Wisdom (Medicine) check by a trained practitioner after a one-hour acupuncture treatment will reduce the IE by 1 for the rest of the day.

You have trouble with larger body movements, such as jumping, throwing, walking, running, and maintaining balance. You have a −(IE) penalty on all melee attack rolls to hit and Strength (Athletics) and Dexterity (Acrobatics) checks and Dexterity saving throws. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. You may replace one of your other traits with Muscle Control & Gait Difference.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Leg braces, crutches, walkers, rollators, and canes can reduce the IE penalty by 1 for Dexterity checks and saving throws. Braces take one minute to put on and cannot be worn while sleeping, and the others, unless designed for use as weapons, require one hand to be used for balance.

You have trouble making precise movements, especially with your hands and arms. You have a −(IE) penalty on all Dexterity (Sleight of Hand) checks, Dexterity checks to write, or other attempts to use precision with your hands such as playing a musical instrument. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. Transcribing spells with only verbal components into your spellbook takes (IE) × 4 times as long as usual.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Assistance for fine motor control loss takes the form of adapting the space around you to your needs and allowing extra time for anything requiring fine motor movements.