When someone is spotted standing on the edge of a roof, occasionally there are hecklers on the ground yelling “Jump!” But most reasonable people will try to talk the emotionally disturbed person out of harming themselves, because we agree it would be wrong.
But let an emotionally disturbed person decide that he wants to take a scalpel to his genitalia, get his Adam’s Apple shaved, get breast implants and estrogen injections, and he’s applauded for his 'courage', as if mutilating his body is right. No one says anything about his narcissism. It is considered politically incorrect to look askance at his decision, to suggest he needs emotional help.