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Let's trans is a mental illness; whether it is or it's not, let's suppose it probably is do to the high percentage of patients that have coupled mental illnesses. Maybe they're taking medication for those mental illnesses, maybe they're on their way to. So, shouldn't a trans person be allowed to take "medication" for their mental illness? i.e. changing their body however they want, effectively medicating themselves. Then again, ya'll are very quick to want anything that isn't you to die.
When it comes to Pokemon, I could possibly see it happening when a Pokemon is bred with a ditto, something genderless. Maybe it causes something mentally later on, not that a Pokemon would be able to communicate that.
But I figure that if it happens irl, it happens to people in the Pokemon universe, too. Probably just more technologically or medically advanced. I mean, they capture monsters in balls.