And it is time to do some serious mythbusting. In reality, detransitioning almost never happens:
In a recent study of kids who transitioned before 12, 94 percent had not changed after five years.
www.inverse.com
In the few instances that it does, more than half of them still do not identify as cis-gender, and to me, this is just more evidence in favor of embracing and accepting non-binary gender identities. I think that would do more than anything else to reduce the likelihood of young people taking rash action. The remainder are in no worse conditions than the other 94% of those kids would have been without the intervention, actually better because surgery on transgender kids is extremely unusual.
6% isn't "almost never" in my book.
You are mistaken. It is 2.5%. Read more closely.
The remaining 3.5% actually identified as gender non-binary.
"Non-binary" doesn't mean that anything irreversible was the right course of action. And 2.5% is still not "almost never" in my book. Puberty blockers and live as your preferred gender, fine. Surgery--only after living as the other gender for some time.
Actually, the progression goes more like this for young people:
1) "Social affirmation" only at the start, which could mean a new name, new pronouns, clothes, or whatever other parts of life happen to go with being one gender or the other in a particular culture. And years of seeing therapists that keep track of the kid's welfare.
2) Puberty blockers at the normal start of puberty and more seeing therapists to make sure the kid is happy with this. Right now, I am a late-transitioning transgender adult, and I still have to see my doctor every three months, having started in June. That is for an ADULT. I would be surprised if a kid that was taking puberty blockers saw a doctor or therapist less often than that, and I would suspect more, probably monthly.
3) Slowly adding hormone-replacement therapy (HRT) drugs like, in the case of male-to-female transgender youth, estradiol, spironolactone, and progesterone. These are added slowly. More seeing therapists and doctors. Lots more. I hope you are insured. By the way, progesterone is really expensive shit.
As for why it might sometimes be necessary to move a kid beyond puberty blockers to slowly putting them on HRT, one example could be, in the case of a transgender boy, where he feels like his peers do not respect him or take him seriously because he still has a "squeaky child voice." I had a constitutional growth delay, which had a similar effect to being on puberty blockers, and while this might have saved my life in light of the fact that I was transgender on top of having other problems, I know all too well what it is like to look younger than my actual age while in school.
However, the decision to move on to full HRT drugs would be made with the extensive consultation of doctors and therapists. There are probably at least three professionals involved, though some doctors can do the work of two: the family doctor or pediatrician, the endocrinologist, and the therapist. There could be more, depending on your local healthcare system. Furthermore, teachers, school administrators, and other parents are generally aware of the kid's situation. There are many adults at once that are monitoring this situation at the same time.
Furthermore, the majority of parents of transgender kids really feel very uncomfortable with the entire matter. I think that I have proved to any reasonable person's satisfaction that transgender kids are probably born, not made, in other threads. Imagine any politically moderate family, probably with a moderately agnostic but not necessarily atheist dad and a kinda-sorta religiously observant mom that secretly just likes the social scene at the local church and at heart is probably more skeptical than the dad. Put them down as being as politically, ideologically, and religiously moderate as anybody that you can possibly imagine.
And then imagine those people's horror when it turns out that their kid has utterly rejected their birth sex. They do not come around easily on the subject. In fact, the only reason why they eventually do is that, after seeing multiple psychologists, doctors, and faith healers, they eventually settle on gender-affirming care as the only solution that is going to work. This is often only done AFTER alternative methods fail to bear fruit or result in self-injury behavior by the child.
It is a very hard situation for parents to be in, and the assumption that they arrive at the decision to start giving their child drugs lightly is deeply unfair to the families that actually have to do the job of raising these kids.
These decisions are made after years of therapy and consulting with multiple professionals. They are complex decisions, and they are not one-size-fits-all.
In reality, surgery on a kid is not on anybody's minds, in almost every case.