Eleutheria's Metamorphose

You permanently alter the physical characteristics of a humanoid creature's body. After wrapping the area to be affected in gauze and pouring oil over it, you conduct a one-hour-long ritual that manipulates the flesh and bone of the target's body to an extent. Changes achievable through this spell include alterations such as gender, height to a maximum of a 6-inch difference, facial structure, body type, and any other minor aesthetic changes. Their race cannot be affected by this spell. You may pick and choose exactly what changes occur. No ability scores change due to this spell, nor does size. When the ritual is complete the target is unwrapped, and they suffer one level of exhaustion.

Once a creature has been affected by this spell, they cannot be affected again by it for 1 year.