More importantly, it gatekeeps gender affirming care to people that are fucked up enough by it. Some of us are significantly hindered by it, but many others can still work and function in life without transitioning.
My dysphoria is bad enough to make life as a man impossible, but I didn't even know that was the case until I came out. I also don't think it's fair to gatekeep care from people who can function without transitioning. Being a good worker bee shouldn't be the goal; that bar is too low.