That entire twitch site seems like pure brain rot, from what I understand it's entirely giving people money to watch them play games or for women to say your name. The whole thing seems unhealthy from the get-go.
Twitch is hardly pure brain rot, there are plenty of things worse, but the growth and commercialization of streaming have created a lot of problems for parts of the platform. There is some really amazing content on there and as far as I have seen most watchers have Twitch going on with something else. For the really, really massive communities, it does seem like a crapshoot. Whats the point of chat that streams by at a million miles an hour? Then again...you get to see modern day celebrities interacting in real time...for many that is a cool thing to experience.
You are describing a very small percentage of streamers. If you avoid people with over 100 concurrent viewers, you find thousands of streamers who aren't doing more than trying to build communities around a common hobby. And it was my impression that that's seen as a good thing.
All of the streamer/"community" chatter interaction is god awful, low effort, low quality, waste of time. Every content creator I love who has spent more time on twitch ends up gearing their content for the 12 year olds in chat and that ruins it for those who don't want their content filled with "pogger" and other hyper niche fads in the twitch chat.
Honestly, I don't think it is necessarily any worse than let's say sports. You are watching other people playing a game with some people commenting over. Acceptable past time.
Now, as it grows and as certain content becomes more popular it becomes rather less murky and clean. Still I wouldn't call it all bad.
The faux-friendship interactions with chat I think can be pretty unhealthy for sensitive viewers (shut-ins and teens). Like many shitty sites, if you go to the places with fewer people, it isn't so bad. Stick with people with a few hundred viewers, avoid simp-magnets and loudmouths.