I have just pointed out that the issue is complex. A sex change affects nobody but the individual patients and is a matter for them, their medical advisors and no-one else.
What would your thoughts be on charging elevated premiums for people who wish to pursue that path long-term?
As I noted before, part from the risks of the puberty blockers (which people tend to either over or under exaggerate based on their angle), the life long maintenance drugs/hormones that need to be taken have just as much of an association with elevated cardiovascular and cancer risks as smoking. Which is why they have special medical provisions and recommendations that go along with it.
As long as healthcare is something we're all chipping in on (either directly by a single payer method, or in a pooled fashion via private insurance), to say that "it only has an effect on the person themselves" isn't exactly true.
We definitely need more guardrails around the process.
Prominent organizations who operate in this space (and not just random rogue clinics) have implemented some rather concerning protocols surrounding it.
This next part will sound like something from a Babylon Bee satire article, but it's legit.
Several large organizations who operate in this space have adopted a protocol they call FASST (First Assessment Single Session Triage) where they're making some pretty big determinations about whether or not someone is a good candidate for "moving forward with the process" based on a relatively short interaction.
And some have even extended that protocol to include dispensing hormones on the first visit.
What to expect on your first visit for gender affirming hormone therapy.
www.plannedparenthood.org
In most cases your clinician will be able to prescribe hormones the same day as your first visit. No letter from a mental health provider is required.
A large clinic in Oregon states on their website
"Timeline: You can often begin hormone therapy within a few weeks of your first visit"
Boston's clinic (the one that was at the center of quite a bit of controversy) website used to state:
In many cases the clinician will be able to prescribe hormones the same day as your first visit.
(they've since removed it, but it's viewable via the wayback machine)
At the Children's gender clinic in Cincinnati (the 4th largest in the nation), they had the spotlight due to a court case where, despite the judge siding with the teen over their parents (and ruling that the affirmation process can move forward), expressed concern about the fact that 100% of the patients that have gone there have been deemed "good candidates for gender affirming care"... which should raise eyebrows any clinic regardless of what it specializes in. If an orthopedic surgeon was deeming 100% of people who walked through the door as a good candidate for back surgery, people would be watching them closely and understandably suspicious.
As long as some places are fast-tracking these processes, and many people are advocating for these interventions to be taxpayer and/or insurance funded, I think that while people generally aren't entitled to have a buy in on every individual case, they at least get to have a buy-in on the overall procedural approach.