In August 2020, Sterling came out as nonbinary on Twitter, initially saying they accept all pronouns,

but since expressing a preference for "they" specifically (in patreon)

I stopped following him a long while ago. And I give zero fucks about pronouns. Unless I actually care about the person, which in Jim's case I really no longer do, I'm not doing the courtesy to Find out whatever pronoun they've changed to in recent months/years since I stopped giving a fuck.

He still likes being called Trash girl from the gender dumpster, so make of that what you will.

https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy

While gender affirming hormone therapy usually results in an improvement in mood, some people may experience mood swings or a worsening of anxiety, depression, or other mental health conditions as a result of the shifts associated with starting a second puberty. If you have any mental health conditions it is recommended you remain in discussion with a mental health providers as you begin hormone therapy.

Jim has had a long, long history of mental health issues like anxiety and depression.

HRT can mess up with your mental state, which thus affects production value.