To me, it seemed like his biggest issue was all the people who lie about "gender-affirming care" and say things like "puberty blockers are 100% safe and the effects are fully reversible". People like Jack Turban or Michael Hobbes. Sometimes those people would also lie about Jesse, and they would regularly misrepresent things he'd written, or take things out of context. He got caught up in arguing with those people, but it's just a constant cycle of bullshit, because none of his biggest detractors are interested in having a proper debate, nor do they have decent rebuttals to any of his arguments really.
I think he made a mistake by deactivating his account, because it handed troons an opportunity to spread more lies about him; that he'd deleted his account because of the HIPAA stuff, and he'd destroyed his own career. He should have just left the account up, but taken a step back from Twitter, because on the latest Blocked & Reported he admitted that he still browses Twitter every day, just without tweeting anything himself.