free speech doesn't encompass shouting "fire!" in a crowded theater when there is no reason to believe there is an actual fire. because that hurts people, it does actual harm.

misgendering people, whether they're cis or trans, is likely to hurt them. making mistakes illegal usually involves very demanding requirements of negligence, but making willfully hurting others out of spite and prejudice illegal is a lot more reasonable

as for medical and psychological treatments needed by any person to be able to live a happier life, ruling some out just because you don't experience or need them comes across as horribly selfish to me. I hope you never need treatment for a condition that others reject as legitimate, and if you do, that you aren't, like, taking back at another vulnerable group. especially teens and children, who may have to deal with bigotry and intolerance not only in society at large, and in doctors, but also in parents that were supposed to be supportive