I don't explicitly do gender medicine, but I do see transgender patients for other things.
Among all the conversation around gender medicine in minors, how does our knowledge of developmental stages apply to this?
For example, can children below 12 even conceptualise the abstract idea of gender (as separate from sex) if they have not yet reached Piaget's formal operational stage? And when transgender adults say they had known their identity since they were under 12 (often making reference to a time they deviated from gender stereotypes), what does that mean?
Furthermore, 12-18 is Erikson's identity vs role confusion. So even once they do learn about the abstract, is intervening still unwise? I can see the argument both ways, treatment during the period of maximum identity crisis (worsened no doubt by being transgender) may relieve distress during a vulnerable period, but it may also prematurely terminate identity exploration before it completes. I imagine known identity instability in ASD / BPD often comorbid with being transgender exacerbates this issue as well.
And before someone posts that big long copypasta with all the studies that purport to show benefit, that's not the point of this largely theoretical conversation about what children are capable of grasping, and those studies are awful.