As with the Sims adding surgical "transition" mutilation scars, if the point was to be what they wish they were, in a fictional universe, they'd make the character the sex they wish they were.

Especially in a fictional world where "in-universe" mental illness can be cartered-to with magic.

Because it's not about being rid of the metal illness. It's about coercing others into partaking into their delusions.

As with the Sims adding surgical "transition" mutilation scars, if the point was to be what they wish you were, in a fictional universe, they'd make the character the sex they wish they were.

Especially in a fictional world where "in-universe" mental illness can be cartered-to with magic.

Because it's not about being rid of the metal illness. It's about coercing others into partaking into their delusions.