The ebuild defines: REQUIRED_USE="!X? ( !gtk !sdl ) X? ( sdl ) sdlgfx? ( sdl )" It follows that only the USE flag combinations "-X -sdl" and "X sdl" are allowed, whereas combinations "-X sdl" and "X -sdl" are forbidden. Therefore, having two flags adds no additional choice for the user. Only one of "X" and "sdl" should be in IUSE.
You are right, I just tried to use the same logic which is used in the Makefiles. I does not make really sense, especially for the user. I have removed USE="X" for now.