“gender-affirming” sounds like activist language, not unlike “pro choice,” in order to avoid the reality of the situation.
Affirming their gender would actually mean admitting that their DNA is the real deal. No butchery or drug cocktails will alter their DNA.
The original institution, Johns Hopkins, that pioneered trans surgery in this country halted the procedures for 40 years because the outcomes were worse in those that had surgery. The chief surgeon, Paul McHugh, who stopped that avenue in 1965 is speaking out again about the damage being done especially in children.
https://couragerc.org/wp-content/uploads/2018/02/TransgenderSurgery.pdf