I don't play games that don't have a pause button. I'm an adult with adult shit to deal with. That might be as simple as cooking dinner. I don't have long for leisure in the evenings but if I can pause a game in between e.g. cooking, I can play it. If I can't pause, I can't play.
If devs want to say 'fuck you, user, we aren't making our game accessible,' then fuck them, too. Just another symbol of the shit hole that is game development. I don't really care what their justifications are. Online games could be made with a pause button as well if the devs cared about accessibility. It's an industry that takes itself far too seriously, as if games aren't supposed to be a bit of fun. That's what happens when games are commodities, I guess.
It's another factor in gamers being so reactionary; so much of it is de facto the reserve of people without responsibilities or people who don't care about their responsibilities. Down with inaccessible games.