It seems like they can’t live without having to try to groom people, specifically straight males, of course. It looks to me like they realize they have deeply destroyed their bodies (the vessels they live in) and can’t reverse it. So they decide to keep going on with it (the meds) because it’s permanently fucked anyway. They cope by trying to make others do the same stupid shit they did when they “began transitioning.”
Eventually they realize that they don’t want to do this shit anymore, the drugs; their bodies are naturally resisting it all, the self-talk becomes too exhausting, it’s not working, nobody truly cares about the fact that they’re troons anymore, they buy a rope and kill themselves.