guys go ER because when you go years without getting your needs for belonging, companionship, intimacy, validation, and love met then you'll snap, when the mind is starved of these essential factors it will deteriorate rapidly and ultimately break down.
It's like with a car, if you go a long time without changing the spark plugs, changing the air filter, changing the oil, and not maintaining it at all it will break down, the car is not getting its needs met so it will cease to function.
Guys become trannies as a last resort, they trannymax to get the attention their minds are starved from, and they do that to get girls who are pansexual to fuck them.