“11 year olds are NOT aware of any sexual identity issues...”
I agree. The child is only eleven years old! Think back to when you were eleven. What did you want to do with your life? What did you want to be? You either didn’t know or came up with the idea that you would be an astronaut, a model, a figure skater (or along those lines). Did any of those concepts come to fruition? To medically disfigure an 11 year old is horrible.
This is not disfiguring the child. Disfiguring him would be castration and giving him female hormones. This delays puberty so that he doesn’t develop male secondary sexual characteristics.
I believe that there are a few, very few, people who truly in their heads are wired to be the other sex from early childhood. I imagine myself as a girl developing whiskers, an Adam’s apple, an enlarged penis, broad shoulders...a monstrous transformation of my body. I can see such a child responding with self-mutilation or suicide.
Given this boy’s difficult life, the stress of adoption, the lack of a father, the weird sexual politics of his household - his transgender issues are likely not to be innate, but acquired. Still, the delay of puberty could give him more time to accept his masculinity (with good therapy in a better family setting.)
At least the law and medical standards do not permit him to be castrated until he is eighteen.