No but for real, I agree 100%. I hate this idea that the challenge with Astarion is you have to "fix" him, and if you prefer AA or even like AA, then you're the one with psychological issues. But the idea that you have to, or can fix someone, can lead to super problematic relationships and psychological issues in real life too. It doesn't actually work in real life; it just leads to codependent and abusive relationships. It's fine for people to prefer the UA path, just don't pretend like in an equivalent real-life experience, AA romancers would be any more damaged than UA romancers.
The only psychological issue is Astarion himself, and compared to real life, he is a case for prison with life-term sentence. He should never have the chance to be released again. He would most likely reoffend. It doesn't matter whether he has had traumatic experiences in the past, a personality cannot be changed. Trauma is never an excuse for murderousness and sadism. Nobody should feel sorry or even empathy for e.g. Ted Bundy or other criminal sadists just because they didn't have a great childhood, were abused, mocked or other reasons, like the "easy access" to violent porn allegedly led him (hahaha, Ted Bundy) to it. [I can really recommend the interviews with him, very interesting how he tries to manipulate, how he is charming, lying and only looking behind this fassade reveals his true self]. Not everyone who experiences trauma or other difficulties in real life becomes evil. It is always an interplay between character traits and life circumstances that enable a person to commit murder and cruelty. Players who judge other players for going the AA route and claim their Astarion is healed and cuddly should be kicking themselves. Character traits (like murderousness, dangerous sadism) cannot be cured. They don't have a guilt consciousness. Even less would it be possible, from one second to the next (just by denying the ritual or killing cazador) without a long-term therapy. The UA story is pure fantasy and has nothing to do with RL. I don't want people who have a penchant for sadistic killing to be at large in the RL. Beside of that, also Astarion himself is pure fantasy: A personality like him I doubt exist in reallife: Dangerous sadism, murderousness and narcissism but with "real" empathy for other people or his romance partner and suddenly with guilt consciousness? No. The closest thing to Astarion in real life could be a sociopath, but they feel no empathy or guilt consciousness. Astarion himself is a "dangerous" fiction and there is no need into blaming or mocking players for clicking fictional answers in a game! It's fiction in all paths. Only people, who mock other people for their ingame choices, that's for sure real and - well - the opposite of nice.
"I would, thank God, watch the universe perish without shedding a tear."