Similarly how and why someone who is trans can exist in D&D when there are multiple ways to literally change from one sex to the other, beneficial or otherwise as it can range from Divine blessings/wishes to cursed items someone made. If the movement was sincere the "curse" of wearing a belt for the rest of someone's life would be a pittance of inconvenience if it actually did what so many claim to want done. But they don't, because it would then remove their special label where they can talk about how they are vegan/into cross-fit/trans.