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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.
This entire debate is more radioactive than Godzilla because it's not just about Bill says he is a Real Woman. If Bill tries cutting off his own arms and therefore surgically removing his arms and giving him prostheses is the best thing for Bill, it doesn't affect my life. But what we have is the equivalent of Bill not alone demanding you cut off his arms and give him prostheses, then everyone has to at least pretend they believe prostheses are the exact same thing as having arms. It's Bill barging into events and claiming that if he can't compete in snooker matches (insert sport of your choice that needs good motor control) against professional players, then it is discrimination and the rules must be changed. By the bye, didn't we go through this already with Oscar Pistorius? Rather an unfortunate example, I agree, but the same debates over "does he have an unfair advantage?" took place.
It's Bill saying that unless we all agree that chopping off your arms is a sane, normal, healthy activity, we are ableists and amputationphobes and that a law to protect him and those like him must be passed. It's amputee activists creating cute cartoons to kids that hey, maybe they too might be like Bill and this is how you get the doctors to agree.
Right that is why we are keeping the discussion contained to specific areas. Just to be clear, just because I don't think that saying not doing x is not abusive does not mean I think we have to actually do x. There might be a lot of other reasons not to.
If it were true that chopping off someones arms was the best option for them but it cost a billion dollars I'd still be saying sorry Bill, even with the risk of you killing yourself by self-surgery the cost/benefit ratio just doesn't work out.
My point is simply that if you are observing an impact of doing or not doing x that isn't on its own abusive behavior. You aren't yourself threatening to commit suicide. I think if it were, "If we discontinue all treatment for depressed people it is likely suicides will increase" that is most likely an uncontroversial statement, even if it were being said by an anti-depression activist.
Likewise a trans person saying if you don't accept us/allow transition/whatever could mean additional trans people killing themselves is if true something to take into account. It might still not be worth it, depending on the costs (both financial and social) but it isn't in and of itself abusive. It's not a threat because they can't actually control what all other trans people do.
I think the same argument can apply to the people that the activist is talking about: If they're responsible for their own actions, we aren't obliged to accommodate them. If they're not responsible for their own actions, we are obliged to accommodate them, but they should be treated as mentally ill.
Also, this situation can be described as the activist enabling people who make abusive demands and passing on abusive demands, even if he is not being directly abusive himself.
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