We didn't go into personality disorders that much but if I remember correctly they all stem from childhood trauma. I'm sure there is some brain chemistry too. That being said they are people first and deserve empathy.
People who claim they will never use pronouns have no issue with substituting nouns. They have so much hate for people who are trans that they even hate people who support them by listing their pronouns. They attack pronouns because it makes them "anti woke" instead of bigoted.
Hey @GovRonDeSantis, clearly you're struggling, distracted, and busy playing politics with people’s lives. Since you have only one overriding need -- attention --let's take this up & debate. I’ll bring my hair gel. You bring your hairspray. Name the time before Election Day. @CNN
Here’s an idea for Chris Licht, the new head of @CNN. Set up a debate — one-on-one — between @GavinNewsom and @RonDeSantisFL. Two governors of big states, potential presidential candidates. Prime time. Ratings I bet would be huge. Who would have the courage to show up?