If I went to my doctor, and said I didn't like my right arm, and wished for it to be removed, what should my doctor do?
My right arm is healthy and normal, and I would be rather seriously disabled if I were to have it removed.
I think it should be obvious that a desire to have my right arm removed can only come from some serious mental disorder; and that going along with my request to have it removed would, in fact, be harmful to me, and would bring no benefit. If my arm were removed, I would still be just as mentally fucked as before, but now my body would be fucked as well.
I say that to remove my arm, no matter how much I begged for it, would be an act of malpractice, for which any doctor who has part in it should face serious adverse consequences—at the very least, the loss of his license to practice medicine, and probably criminal charge and prison time.
How is “gender affirming care” any different than that?