These people are artists. These people are musicians. They're taking it out and trying to express it that way.
Brian Hugh Warner (born January 5, 1969), better known by the stage name Marilyn Manson, is an American singer, songwriter, musician, composer, actor, painter, author and former music journalist. He is known for his controversial stage personality and image as the lead singer of the band Marilyn Manson.
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Read more about Marilyn Manson on Wikipedia.