The way I look at it is that the mind deals at a base level in symbols. Words are nothing if not symbols. So it is not that people get hung up on words so much as that words trigger associations to what you term “the real issues” – they become rough (and sometimes actual) equivalents to their minds. Taking the example of an ex soldier with PTSD, a particular sight, sound, or word(s) can put them into hyper-vigilance and make them relive various traumas, sometimes in ways that are harmful to themselves and/or others.
So in that case I’d think you’d need to regard a hypothetical trigger word or phrase as a proxy for the real issue and it might be VERY prudent for the person to avoid that trigger UNTIL they’ve dealt with the real issue. Which means that someone insisting on saying what they please regardless of the consequences for that person, would just be an asshole, at least outside a controlled clinical setting. And I very much doubt that’s where you really want to go with this.
As I and others have said, there’s a balance in these things. I think we’ve all agreed that choosing to take offense where there’s no objective harm or harmful intent is not the same as reacting to being attacked for attributes they can’t change (e.g., skin color, or where they were born). But even there, that some people can’t tell the difference can at times be due to psychological trauma that isn’t going to disappear at the snap of a finger, either. An example of that would be my trans granddaughter. She doesn’t allow her family to display pics of her pre-transition. That’s objectively unreasonable, but they go along with it for now because they understand what it symbolizes to her and she’s likely to grow out of it when she’s able and ready. That trigger could just as well have been word-symbols rather than photo-symbols. They play along out of compassion. I think that’s appropriate, at least to a point.