Back in the days when there were gatekeepers, doctors would actually refuse to treat you for gender dysphoria if you were suicidal. Because suicidal people aren't thinking clearly enough to be making such an important choice, and their actions could be seen as abusing the treatment as a means of self-harm. I think people also make that argument because they feel they need to be manipulative so that others will let them do what they want to do. If the world were more enlightened, we wouldn't have such issues.