[jtaft]

I appreciate you wanting to to understand a different point of view.

Why is it the author could understand certain actions only if someone has a medical condition?

Surely there could be multiple other reasons.

The context in which the word is used isn’t appropriate. Many find using the word when referring to a medical condition to be derogatory.

Saying someone/something isn’t a derogatory word isn’t kind. The words association and connotation is still there.