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Respec is an MMO term that means changing ("respecifying") part or all of your character's current build.

In DDO you can respec:

Enhancements can be reset using platinum or astral shards while in a public area. The platinum cost is determined by the number of action points currently spent, as well as a multiplier determined by the number of enhancement resets you have done recently. When resetting your enhancements, you may choose to reset all enhancements at once or an individual tree.
This also requires a payment of gold that increases with your level and can only be done once every three days. Each spell respec allows only a single swap, Unless you use a Blood of Dragons
This requires payment with either gold and Dragonshard or Astral Shards, detailed here. Once per life a feat swap can be done for free by completing the Hall of the Mark quest from Lockania. Only one feat can be respecced every three days.

It is possible to respec your gender and your race through True Reincarnation since update 20. Previously only race could be changed on True Reincarnation.

Enhancements Spells Feats Skills Stat
Build point
Class Race Alignment Appearance Cost Notes
Class trainers yes yes - - - - - - - - gold -
Fred - - yes - - - - - - - various Siberys Dragonshards or Astral Shards or Hall of the Mark quest -
+X Lesser Reincarnation yes yes yes yes yes 28 → 32 up to X levels - - yes From 895 DDO points Available in +0, +1, +3, +5, or +20 level change varieties.
+X Greater Reincarnation yes yes yes yes yes 28 → 32 up to X levels - - yes - Function rolled into Lesser Hearts with Update 20. Existed in +0, +1, +3, or +5 level change varieties.
Epic Reincarnation** yes yes yes yes yes 28 → 32 - - - yes 1295 DDO Points or 4,200 Commendations of Valor or 42 Heart Seeds -
Heroic True Reincarnation*** yes yes yes yes yes 28 → 34
32 → 34
34 → 36
full levels yes yes yes 1495 DDO points or
20 Tokens of the Twelve
Iconic Characters undergo Iconic True Reincarnation instead.
* Build Point Upgrade Going from 28 to 32 point builds with a Lesser or Greater Reincarnation requires the 32-point build option unlocked (either through 1750 favor on a per-server basis or purchased from the DDO Store for 1,495 DDO Points)
** Epic Reincarnation - This acts as a Lesser Reincarnation with the added bonus of going from Level 30 to Level 20.
*** True Reincarnation - You lose all XP, quest flags, raid completions, and favor used. This is closer to remaking the character from scratch than respeccing.