You can convert to USD stablecoins, which is still an off ramp, but has the benefit of no AML on decentralised exchanges.
It also works the other way, so they are an on-ramp, just with a slightly higher fee. However i wouldn't 100% rely on these regulated stable coins as an off-ramp if the crypto market implodes and everybody runs for the exit.
I've been using a bitcoin debit card for years.
I've also purchased thousands of dollars of stuff, from NameCheap renewals, Vultr hosting, to Amazon gift cards.
AKA being overcharged to spend fiat.
Couldn't agree more.