I haven't participated in this discussion until now, but just chiming in on this – I don't think there's anything wrong with not caring about children or fertility. There's an entire pan of society that adheres to childfree beliefs, and claiming that a woman who doesn't want children is some kind of abomination or failure is kind of an outdated way of thinking.
Ultimately, how one views themselves is influenced by how others see them (and thus how society defines gender). We judge whether someone is a man or woman by their physical appearance, behaviour, and, yes, genitals. Varying degrees of dysphoria lead to different consequences, and while someone would be fine with 'passing' and being recognized in public as a person of the other gender, others are too deep in the condition to handle seeing a cock or a vag down there.
I think that, if the entire medical process (in terms of mental health, pre-surgery treatment, …) was better handled, and if we had more support options for those abandoned by their families (family rejection and substance abuse are significant predictors for suicide attempts), a lot more people could be saved. And then, of course, you have the whole discourse about whether or not accepting trans people as an 'attribute', rather than a mental illness that needs to be corrected back to their sex, is worth the societal impact it will have. That's another subject.
But it's definitely more complicated than just having kids or not. We live for more than that.