Go Away- “ Hellraiser Movie Casts Transgender Actor Jamie Clayton To Play Pinhead”
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For a lot of them it is their identity. Majority of them are mentally ill, completely messed up and it has become the only identifiable trait to their illness.
I'm not even writing this to be mean, it's just the truth. It's best exemplified in this post from a lesbian who had an identity crisis (spoiler: she was sexually and emotionally abused as a child by a man and developed a seething hatred for men): https://archive.is/Lbqbp
Notice how she edited the post to toe the Rainbow Reich line again, and said it was "her truth" at the time, even though her original assessment was correct, insofar that she was only a lesbian as a response to trauma and sought comfort where she couldn't find it elsewhere, even though it wasn't comforting at all. Her crisis came from existential awareness that she had no other traits other than identifying with a sexuality as an entire personality trait to compensate for the shame, hurt, depression and trauma. But even then it didn't help.
This is common for a lot of them, and it's why they generally suffer from depression and lots of anxiety, along with a lot of health and hygienic issues: https://ajph.aphapublications.org/doi/10.2105/AJPH.2009.177329
Burying the trauma instead of addressing it results in a lot of chronic disorders for them: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2530417
However, most get roped into the whole alphabet soup community where they get caught in the feedback loop of feeling shame, depression, and anxiety from the lifestyle but are perpetually told that they should have "pride" in their degenerate lifestyle and hedonistic behaviour. They need this constant praise from the community to justify continuing the downward spiral of maintaining the lifestyle. In turn it just keeps making things worse, so it becomes the defining quality (or lack thereof) of their identity because they need that constant validation from everyone to seek "pride" in their shameful acts, which is why they need to keep broadcasting their life everywhere and to everyone, expecting everyone to praise them for it, because they actually don't like the lifestyle.
But that oscillating cycle of depression, validation, shame, praise, anxiety, and acceptance is almost next to nigh to break without serious intervention.