I noped out around the time she started talking about “crumbling rectal tissue”
There is a podcast called Gender: A Wider Lens run by two professionals who work with gender dysphoria in young people, and they have an episode that touches on this:
ROGD and the Struggle to Grow Up. They don’t describe it as full-blown Munchausens, but a lot of the benefits the patients get out of it are similar. A lot of their (particularly female) patients basically don’t want to become adults and go out into the world, so they adopt a ROGD trans identity almost as a delaying tactic, because then they suddenly need medical care and pampering and attention and are able to get multiple surgeries that regress them into a helpless childhood state.
Anyone who has had major surgery can tell you that it really does regress you: you have no choice but to rely on others for everything, you’re physically incapacitated, and basically you get to lie around on opiates while people bring you food and baby you. I can see how that, combined with being told how stunning and brave you are for getting this affirming surgery, would appeal to a teenager who is trying to delay independence and adulthood.
Of course the price of it is having your tits chopped off and lifelong complications, but a lot of young girls cannot grasp that.