As a trans person, I sort of live in the space of "am I making this choice because I actually want to or because I'm trying to fit into society better?" That is, many of my choices about my body could be argued to be not entirely a freely made choice.

But I'm not actually very interested in digging into my motivations for the choices I've made. I thought about them quite a bit before I made them, but now that they're made, I kind of don't care how pressured by society I was when I made them. And if anyone else tried to tell me that my choices were not my own or not freely made? Yeah, fuck right off with that.

The same applies here. You're probably right, Laura Loomer and all the rest are making a choice that is, of course, mediated and informed by society. But I don't care to dig into her motivations, and I am entirely unwilling to say that her choice to get the surgeries she has gotten is anything other than a free choice made with free will