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The reason many people support youth transition measures is because there are many adult trans people who didn't transition until adulthood who were ignored and sometimes abused for expressing their desires in youth, even pre-pubescently. If you're really concerned about poor decisions before someone understands the implications fully, the magical cut off date of 18 isn't even scientific considering the brain doesn't reach full maturity until later. Testosterone has some hard to reverse effects on voice and bone structure, because of how sexual dimorphism works, that's another reason a lot of people are against completely delaying any intervention in MtF patients. The actual standards of care have always prevented/recommended against any youth surgery and even in many cases only allowed puberty blockers to delay the final decision rather then beginning full HRT. Youth transition is recommended to only be social with puberty delaying. There may be doctors that don't follow the standards of care, but yeah.