The other day I went to the wedding of the son of a good friend of mine and one of the bridesmaids (I think it was the bride's cousin) was a manly looking woman with short purple hair that honestly made me wonder if she wrote for the Mary Sue, Star Wars, or worked for a video game company or Marvel/DC.
The actual ceremony was no more than 25 minutes and I couldn't help wondering why she couldn't just wear a dress (of course she dressed like a dude and stuck out like a sore thumb amongst the other bridesmaids) for that little bit of time. I said a prayer for her because she is young and maybe one day she will realize that she looks silly trying to act like a man.
I remember when I still worked in HR the first time I came across the phrase "gender non conforming" or "doesn't conform to traditional gender roles". This was like 07 so I didn't think anything of it, but I never would've imagined it would get as insane as it has.
Its even less than that. Most of them get them as a masochistic dopamine hit to counter thier depression.
Girls like it are constantly posting "need a new tattoo" everytime they get sad because it gives them that temporary relief from their own pathetic existence. Same with the holes and dyes.
The appearance change is just a secondary benefit, the bigger purpose is the needle and bleach giving them pain and a feeling of "rebellious taboo" that keeps the darkness away for another day.