It's a lot better than it used to be when I started. Fender have gotten a *lot* better than they used to be. Not so many years ago, you had to go all the way up the Fender line to the MIA 57 P Bass before there was a left handed option with a maple fingerboard; at a time, there was also no standard P Bass option available left handed south of the US Std one (rosewood board only). Most makers now have at least one token lefty model, though generally smaller brands are better this way than the big boys. You get a lot of limitations on cosmetics. Maple boards are rare at the cheaper end; of a half dozen colour options, you'll often find only one left handed, usually - sigh - yet another sunburst. Quirky models - i.e. anything not aping a Strat, Tele, LP or *maybe* an SG, you can often forget about. Fender have gotten much better for left handers, though I well remember when the first run of Mexican Jagstangs arrived, and the model was not available left handed. Yeah, the Jagstang, as designed by Kurt Cobain... Mn. That said, Squier recently dropped the 50s CV Strat from being available left handed, though they still do the 60s one. Can't be entirely that weird preference for rosewood (or similarly dark) board at the affordable end of the market, though, as they still have the CV 50s Tele lefty.
Whenever I get around to the Gretsch 5420, it's going to mean more expense. Gretsch don't do a l/h 5420T because Bigsby don't do a licensed trem in left handed configuration - for a southpaw, there's only the US version. They did a lovely LE run of 5420T L/H a couple of years ago in Pelham blue purely because there was a foul-up in some sort of ordering process and they ended up with a bunch of lefty trems, but they don't do it as of standard because it hits the profit margin at that priceband too hard. I hold out hope they'll do some decent colours lefthanded soon. I mean, the orange is a classic, but it's as overdone now as burst. I might consider the black and get it pinstriped, though...
Ironically, I think the left handed market, while still not fantastic, has improved enormously in the last decade in part due to the guitar market shrinking overall, so lefties suddenly matter a bit more in terms of sales.
Other than that, it's not so much a big deal. I occasionally wish I could have my pedals re-configured so I could plug the lead in the left so it's not running across my body so much, but that's not the end of the world. The one bonus of the limitations of left handed availability is that it does push you to consider what's available rather than just buying from the Big Brands (e.g. Tokai will often offer a left hander that the "real thing" simply don't make), plus it typically also means you don't get caught up in fads!