In an IRL conversation and then in another with Sarah Lynn Morgan, I got to thinking about names, and how important it is to a person to be called by a name they've internalized. From the time most people are little, they hear their name again and again. It becomes >their< word, a very personal, emotional thing. If there is a negative feeling associated with that name (as may be the case when one has massive problems with their gender, and their name is very gender-bound to the painful gender) then the name becomes painful to hear.