"my pronouns are he not him because I'll never be him"
(I don't understand the difference between he and him in this meme clearly, because grammatically, it refers to the same thing😢) 是什麼意思

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The pun in this meme is that this person (the one on the meme or the one sharing the meme), he will never be HIM (some other, cooler guy, "the guy she tells you not to worry about").

That's why this person is saying, as a joke, that his pronouns are not he/him, but just he.
Hope this cleared that up! x)