It’s at least partly due to parasitic infections. Many parasites give their hosts the urge to self mutilate. Making self mutilation fashionable causes the infected to reveal themselves earlier.
Ask your doctor, or favorite politician why it is that pets & livestock get parasite schedules (antifungals and antiparasitics prescribed and taken at predictable intervals), but there is no parasite schedule for humans. The doctors who get angry are showing their hand.
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