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That feels a bit oddly phased. Presumably it is the patient who is expressing a desire for this, and going through a fairly lengthy bureaucratic process - especially for anything non-binary. I don't think there's a bunch of doctors out there going "have you considered transition?" I would indeed find it super creepy for one's personal doctor to be offering recommendations like that unless the patient is listing off dysphoria symptoms.
That said, if someone knowingly undergoes surgery, and this routinely makes those people happier, I don't see any reason to stop it. I support people doing other forms of cosmetic surgery, getting tattoos, etc.. My general understanding is that very few people regret these surgeries, partly because there is still generally a lengthy bureaucratic process weeding out anyone doing this on a whim. If it makes them happy, why not?
I see nothing odd about it. A few years back there was a story about a patient who went to a psychologist, and expressed a desire to be blind (and, if you're curious how it ended, the psychologist did oblige), it's still the doctor's job to discourage rather than encourage it, in my opinion.
The process is neither lengthy nor particularly bureaucratic.
The issue I brought up is that there are doctors explicitly advocating for removing all guardrails, including age, history of mental illness, and even the incidence of gender dysphoria. The response that they're (probably, maybe) not going out of their way to sell transition, does not alleviate my fears stemming from the issue I brought up.
Well, you originally made it sound like it's a question of best medical practice. If diagnosis doesn't enter into it, and we're just fulfilling people's arbitrary desires, hoping it will make them happy, it would appear the original argument is invalid.
In any case the reason that I see to stop it, is that young people are not known for their good judgment, so I don't think we should be letting minors undergo irreversible procedures on the basis of their sayso.
There's also an argument for limiting access even for adults, but if we can't agree on minors, I don't we'll get far regarding adults.
I'm not talking only about surgeries, but about the whole "gender affirming care" package (blockers, hormones, surgaries). Further, my entire point is that specific doctors, and organizations like WPATH are explicitly working towards abolishing any such process, wherever it exists. If the reason why you're not worried about people undergoing these procedures is that there are safeguards in place, then I think the biggest worldwide association of gender care providers arguing to abolish them should be a bigger deal to you.
In any case what you said is inaccurate. Until recently you could get all of these things, with zero questioning, and few bureaucratic hurdles, even as a minor. In response some jurisdictions decided to clamp down on the practice, and impose age limits through legislative action. In other places, this was done through medical oversight institutions finding little to no evidence for the effectiveness of the practice. But there are still many jurisdictions that did not regulate the practice, and even doubled down on making it even more accessible.
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