Many of the ICs have a restriction that the top side transistor must not go below ground.
Many of the ICs require the bottom transistor and the PWM be on the same ground.
With transformer isolation the transistors do not have to be on the same ground as the PWM.
For many decades I designed quiz-resonant power supplies with 1000V, 1200V, 1500V and 2kv transistors. (not MOSFETs)
Many of those transistors only came in a TO3 case. The Collector is the case.
Every one but "us" connected the Emitter to ground and drove the Base. (simple) Problem is the Collector has high voltage on it. (850 to 1350 volts) Usually in the range of 30khz to 120khz. If you touch the collector it will burn the skin off. Very dangerous. You must insulate the transistor from the heat sink. The insulators are pushed to the max and the bolts that hold the transistor must have insulated shoulder washers. There was many problems with these insulators not surviving over time.
We chose to connect the collector to the supply, (75 to 200V) and let the B-E have the pulse on it. So the insulators needs to with stand only 200V. (safe and no more exploded insulators)
Because we understand transformers; I used the "Base Drive Transformer" as insulation.
Simple drawing of "high voltage switch". It is used some thing like a Emitter follower.
"Why a capacitor across the transistor?" These HV transistors are slow. The C and L(s) not shown make a LC. The supply is in resonant mode. This reduces the power lost in turn on or off. Allowing very high frequency switching.