Read it a while ago.
Ending affirmation, far more emphasis on psych care over medicialization (blockers, csh, surgery), following sweden and Finland - blockers only as part of a formal study, warnings around social transition, resating that most kids (left alone) will grow out of it.
Prior to these changes, dr cass completed systematic reviews and found blockers and cross sex hormones lead to little or no benefit. Which is why only the most extreme cases will be recommended for them and only in the context of studies that will last in to adulthood.