It makes sense. When you've been abused by awful parents, you'll try to distance yourself from everything to do with them, including the identity associated with them. Changing (nick)names, moving long distances, studying something odd, finding friend groups in niches you were never a part of before, all of these things can be done to try and cope with trauma. Hormone therapy and genital mutilation is just a cousin to the drugs and tattoos that have been shocking parents for generations. But this time, society doesn't see the problem.