And it makes no exception on feeling nearly killed.

Why do you say 'feeling'? I meant what I said.

Over 40% of transgender people attempt suicide. Nearly every transgender person I know has attempted suicide. I would have committed suicide if I did not transition. Not only because dysphoria causes depression, but because of other mental issues it was causing me, like feeling my mind split at the seams and being incapable of experiencing a normal range or level of emotion (all of my emotions were extreme, and wrong to me). Dysphoria is often fatal if left untreated, and the only treatment for it is transition. We've tried other treatments. Most trans people have been through months of therapy related to their dysphoria, and transition is the ultimate result.

That is not to mention the negative spiritual effects of dysphoria. These are harder to describe because they are more abstract, and vastly more personalized. In my experience: it hits primarily sense of self, and sexual identity (and from there, the ability to relate to others). Existence innately involves experiencing gender, and those who experience severe dysphoria eventually can no longer assert themselves because of this -- "I" is innately linked to one's own maleness or femaleness, and when one is denied their basic selfhood, their basic identity, they die, in a very real sense. That generally also results in suicide, because of the loss of the will-to-live/will-to-existence. Again, my experience, and really abstract.

You could argue that even that doesn't matter, and that if "existing as a woman" kills me, then I should die, but at that point I can no longer really use that philosophy because of how quickly it collapses (as any foundational statement that says "I should die" does, because of our will-to-existence, doesn't it?).

Every moment lived as a gender one is not is a moment spent taking damage to one's own sense of self. Enough of that damage accumulates, and people kill themselves, or are effectively 'walking dead' anyway.