More than that, it looks like multiple personality disorder, too. Might have had trauma or abuse to have that amount of self-loathing (fad girls don't get this dark) enough to disassociate and harm herself- also a lot of the girl-to-boy or to-lesbian cases, making oneself ugly, when not started by social group hysteria, is started by having been raped and not wanting it to happen again. Not existing it, just observing. Obviously many rape victims don't become homicidal maniacs.