Some lore!!

Ishtar was one of the first in her area to transition, and did so as a blaziken. The road to transitioning was extremely difficult for her, and it took a lot of fighting with everyone she knew to get to this point. She is disowned by her biological family but doesn't regret being one of the few to pave the way for transgender Pokémon in her region. She's a bit of an unsung heroine, but still spends her energy on training and studying philosophy with her radical buff friends. (Ill draw them sometime. I promise)

Layla was fortunate to get a good doctor but hasn't come out to her controlling family about it. Hell, she's kept everything to herself. To them, shes studying some wishy-washy high honour profession, completely unaware that their "son" is a goth transgender Muay Thai prodigy.

Tina is my chronic illness conduit. I'm kinda expression my endless frustration with the medical system with her. Plus, being a fat, hairy femme myself, I can express my unique experiences believably with Tina. It gives her a canon and believable explanation on why she looks the way she does (not that she needed it). I also think it's funny a hippie character like her would beef with doctors, idk why.