they "have to" because square-enix has exclusive publishing rights for dragon quest and square-enix executives think these changes have to be made for the games to sell, so they tell yuji horii to make those changes. obviously they don't "have to" in the sense that it's legal to release games without those changes, but yuji has to follow what his contract with square says. obviously when yuji signed that contract decades ago he couldn't foresee that in the future square-enix would tell him he needs to change male/female to type 1/2 to publish the game.
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