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The game design perspective is an interesting lens to take to this. People are 100% in control of whether or not they threaten to kill themselves. If this yields any advantage the meta will develop to always threaten to kill yourself.
If they are suffering from a mental illness, arguably they are not 100% in control of their actions or words.
Then it would follow that they can't be afforded 100% agency.
Indeed. But can anyone? Let's say being suicidally depressed gives you 70% agency. You can make most choices but in a depressive episode, society may try and override your choice to kill yourself (if it can) by treating you whether you choose to or not. It will then discharge you, offer you therapy or drugs and so on.
If dysphoria does lead to increased levels of suicide then the same response would be to..forcibly transition people whether they want it or not? Remember when we believe people do not have agency due to mental illness, we generally act to treat their illness whether they want that treatment or not at that moment.
So, there is another kind of dysphoria that I think is probably a closer metaphor, Body Integrity Identity Disorder, in which people feel like they have too many limbs, and desire to cut one off. If someone presenting that dysphoria says "I want to cut off my arms, and you have to tell me it's a great idea and I'm stunning and brave, but also pretend forever that I never had any arms in the first place, or I will become so inconsolably distraught that I might kill myself"... would you go grab a hacksaw and fire up the gaslights? Or would you think that maybe this person shouldn't be allowed to make that kind of decision for themselves, and they need to be forced to get some regular therapy and evaluation by sane doctors?
That depends, have they started to try and hack off their own limbs with a rusty hacksaw? Then assuming we can't actually treat the mental part of the disorder, then yes surgically removing their limbs so at least they survive the procedure might be the best option. Our options aren't necessarily magical cure, let them chop limbs off, chops limbs off for them, lock them up forever. It might only be, let them chop limbs off, chops limbs off for them, lock them up forever, at which point limb lopping might be best.
For trans people who are suicidal there does not appear to be a pill that will fix it. The treatment is making the outside "match" the mental internal state because we cannot reliably change the mental internal state (and even if we could, are they the same person? or are we just killing that version of them?). I know a person with bipolar disorder who refuses to take medication for this reason, because the person they are on medication is to their natural state not them, it is some stranger who thinks sluggishly and brokenly. I don't know what the correct option is there.
So imperfect, even shoddy transitioning may be the best option actually available.
I'd be more amenable to that if it seemed like therapeutic solutions had actually been tried and found wanting. Instead, it seems like therapeutic solutions have been deemed mean and politically incorrect, and not tried. And I get the metaphor with bipolar, but bringing this back to the original point, I am not responsible for someone else's behavior. If Kanye West doesn't want to take his meds, then he gets to deal with the consequences of his unhinged behavior. If you really want to transition, go for it. If you want to surgically turn yourself into a cat, or an orc, have fun! But when you threaten self-harm if I don't buy into your delusional framework, you're either too ill to get to make those decisions for yourself (and need to be committed and treated for general suicidal ideation separate from your gender issues), or you're an abusive piece of shit.
Again though largely, they are not themselves threatening to commit suicide themselves. They are saying if you do X or don't do Y, it increases the likelihood of some trans people committing suicide. Whether the person saying that is or is not trans themselves does not have any bearing on the truth of that statement.
If they say if you don't do X I specifically will kill myself then that is a different statement.
I think this is a distinction without a difference, a fig leaf of an epicycle. The context in which the argument is made is always a hysterical, histrionic affair in which responsibility is viciously externalized. "Your epistemic skepticism is LITERALLY GENOCIDE!!1"
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