I mean yes, I think anyone should have the right to CTB for any reason as long as they're of sound mind to make the decision and they're sure it's what they want. But as a queer and trans person myself, it makes me really sad that so many of us die for that reason. I think it's usually more due to the stigma, including internalized stigma that makes people think there's something wrong with them when there really isn't. IMO, this includes reasons like not wanting "the lifestyle" or wanting to be like everyone else.
With the issue of wanting biological children, most LGBT people are capable of having biological children, sometimes through sperm donation or surrogacy. Trans people who get bottom surgery can bank sperm or eggs beforehand if it's important to them to have biological children in the future.
And yes, gender dysphoria can be absolutely brutal, but most (though not all) sources of dysphoria can be mitigated through various forms of social or medical transitioning. I really believe that the vast majority of trans people can mitigate our dysphoria to the point where it doesn't make us miserable if we have access to what we need, like therapy if we need it, hormones/surgery if we want them, things like makeup or binders etc. I hear so many trans people wanting to CTB for reasons like "if I haven't started hormones already at my age I'll never be able to pass," which is not true in most cases, and there's no way to be sure unless you try.
It's sad that our society is so homophobic and transphobic, and that it causes so many people to lose support from their families and communities. It sucks that discrimination in employment, housing, and healthcare are so rampant that a lot of people just can't get into a better situation, like moving to a more accepting area or getting what they need to alleviate their dysphoria. It's fucking terrifying that so many states are introducing anti-trans bills just to make our lives harder and to vilify us as some kind of abomination that women and children need to be "protected" from.
I hope someday there will be a world where people don't want to CTB just because of their orientation or gender because being queer or trans is just considered a natural variation of being human, and our communities will accept and support us and make sure we have access to whatever medical care we need without years-long waiting lists.