abilities you have to harm yourself to activate

Attack on Titan: You need to bite yourself and draw blood in order to activate a titan form

My Hero Academia: In the beginning, Deku’s body couldn’t handle One For All, causing serious injury every time he used the power

One Piece: While not causing external damage, Gear 2 still causes Luffy’s heart rate to speed up artificially, which actively takes time off his lifespan.

Persona 3: Using an evoker shaped like a handgun, while not literally shooting yourself in the head, is still meant to cause a severe enough psychological reaction in order to summon one’s persona.