The problem with a lot of sci-fi is that if you considered what effects the technology would truly have on society you very quickly get a situation that is so different from the common experience of the audience that most can't easily get on board any more.
If the Federation allowed the full range of genetic engineering that we know they have the tech for, nobody would get old or die of natural causes. Gender and even species would be fluid. People could have arbitrary numbers of parents, or family relationships that the word "parent" doesn't meaningfully apply to. I would love to watch a show in a setting like this but I suspect that my taste wouldn't be so common. And the special effects and makeup budgets would skyrocket.