The entire selling point of plastics is essentially that they are not very biologically active.
Gold, on macroscopic scales, is yellow, inert, melts at 1064C, and is a conductor.
Gold, on nanoscales, is wine-red, purple, blue, brown, or clear, is a catalyst, melts at ~400C, and behaves like a quantized semiconductor.
Scale matters greatly when it comes to material properties. And one thing to clear up here: while people commonly talk about "microplastics", for clarity, some scientists divide it up between microplastics and nanoplastics. Microplastics (such as from abrasion, fine fibres, etc) are not harmless (inhalation is similar to other inhaled particle matter, for example - not great for your lungs), but they're not the primary area of concern. Nanoplastics are where the concern is. These come from for example hot liquids in plastic containers close to their glass transition temperatures and the like.
When a nanoparticle enters a biological fluid, it becomes coated in proteins and lipds on its surface (a "protein corona"). The core particle becomes masked and begins to interact with cells and bypasses cellular defense mechanisms (nanoparticles are often used for drug delivery). Microplastics largely pass through the digestive tract uneffected, but nanoplastics cross straight through the intestinal epithelium, and even the blood-brain barrier and the placental barrier.
The evidence of harm is no longer "limited"; this is unfortunately not a factual statement, unfortunately. I would recommend reading for just one example Marfella et al., N Engl J Med. Cartoid plaques of patients were analyzed and studied for microplastics; there were significant accumulations in 58.4% of patients. This in itself is not meaningful, but the consequences were: the patients with microplastics had a massive 4,5x higher risk of heart attack, stroke, or all-cause death. And it appears directly causal: as previous research had suggested that nanoplastics are pro-inflammatory, they studied this, and found that the plastic-positive plaques had dramatically higher inflammatory biomarkers.
The inflammatory problem is what's called "frustrated phagocytosis". When macrophages encounter persistent non-biodegradable particles, they respond by engulfing them. But their enzymes cannot break down plastics. Like a gull that has consumed plastic-laden food in its diet and dies with a gut full of plastics, it will eventually kill them. Because enzymatic degradation fails, they churn out ever-increasing quantities of reactive oxygen species and pro-inflammatory cytokines (to call for help) until they end up destroying themselves - undergoing apoptosis and spilling these toxins into the surrounding tissue. It drives chronic sterile inflammation.
A good analogy is asbestos. The entire commercial selling point was that it was a miracle mineral: completely non-combustible, chemically inert, and basically indestructable. The problem is that those properties carry over into the human body as well: macrophages attempt to engulf and destroy asbestos particles, fail, and undergo an oncogenic inflammatory cascade.
Another example is fine particulate matter. Macroscale carbon is extremely inert. Grind it into PM2.5 particles and inhale that, however, and it's horrible for your lungs, and causes systemic vascular inflammation. A chunk of quartz could not be less harmful to you. Grind it into nanoparticles, breathe enough in, and congrats, you have silicosis.
Also, you have to understand that plastics are not pure; they're loaded with a whole zoo of additives in significant quantities (often even the catalysts used in their production - plastic catalysts are commonly lost in the process of producing their respective plastics). There's colorants, plasticizers, flame retardants, UV stabilizers, and on and on and on, at percentages ranging from a couple percent into double digits. At macroscales, these remain embedded firmly within the polymers. At nanoscales, leaching is trivial; the nanoparticles effective become delivery vehicles for them into cells.
I focused just on one study above, but there are tons now. Parkinsons. Brain penetration and accumulation. Inflammatory bowel. 100% presence in testicular tissue, with higher levels associated with lower sperm counts. Presence in semen, and quantity associated with abnormalities and lower motility. Deep alveolar accumulation from airborne MPs, with foreign-body reactions similar to low-grade silicosis. Hepatotoxicity and DNA damage, with the latter triggering fibrosis via the cGAS/STING pathway. On and on.
Of course, none of these should be surprising, because once you establish that something is (1) pro-inflammatory, (2) breakdown-resistant, and (3) capable of easily penetrating everywhere in the body, you can expect impacts on pretty much every system. To be clear, ingesting pro-inflammatory particles does not mean "you die tomorrow". But low-level chronic systemic inflammation is not good for your long-term health.
From a personal note, I get where you're coming from. I commonly resist taking action that's recommended if it doesn't make sense to me, until I look into it. For an example, as a vegetarian, you'd commonly see things about how vegetarians and esp. vegans should take a marine EPA/DHA supplement (cold-saltwater algal oil, as equivalent to cold-saltwater fatty fish oil). How does that make sense? Humans evolved first as fructivores in the African jungles, then as scavengers on the savannah. Where we ate fish at all it was geographically-specific, freshwater, and warmwater. If EPA/DHA were important, we'd just upregulate our genes. There's an entire subcontinent of vegetarians in south asia, and they seem perfectly healthy. Where's the logic?
And then, eventually, I actually looked into the logic. Our scavenger ancestors also ate bone marrow and brains, which are rich in EPA and DHA. Low EPA and DHA impacts are minor during the reproductive years, they mainly effect you in your later life, so they're not very evolutionarily selective. And actually there is upregulation of ALA to EPA (and to a small extent, DHA) conversion in south asian populations! So? Now I take algal oil.
Getting rid of most of your nanoplastic flux doesn't require massive changes. The main thing is very simple: don't have plastic or plastic-lined containers or teabags touching hot liquids / hot food. Cold is fine; it's heat that leaches nanoplastic particles. Or if you are going to use plastic for hot liquids, use a plastic with significantly higher heat tolerance, as they shed dramatically fewer nanoplastics. Honestly, I think we shot ourselves in the foot with the polycarbonate phaseouts (over bisphenol-A concerns). The bisphenol-A threat picture seems far lower than the nanoplastic threat picture (human exposures are much weaker than dietary phytoestrogens, its estrogenic profile is matched or less concerning than a number of dietary phytoestrogens, and the evidence linking it to actual harm is pretty weak in most cases... possibly PCOS, but breast cancer does not seem to stand up. Dietary phyotestrogens have a great PR agent, while bisphenol-A has a lousy one). Polycarbonate is not immune from shedding nanoplastics in hot liquids, but it sheds orders of magnitude fewer than e.g. polyethylene, polypropylene, etc, so the precautionary phaseouts seem ill-advised.