With mods, anything is possible. I'm certain you can play as a cute anime girl if you really want to!

As for difficulty, it really isn't that bad. Don't buy the hype. It's only hard if you want it to be. Just don't slam your head into a wall until it breaks. That's not how you're supposed to play. Once you hit a point you struggle with, you're supposed to go level and get new gear. It'll be easier when you come back.