Because there are no diagnostic tests for actually being trans and some people mistakenly think they are trans because of comorbid, undiagnosed mental health issues.
statement by former NHS GIDS clinicians :
(extract)
"In the clinical setting we have become familiar with narratives, especially in younger children, resting almost entirely on the most superficial of signifiers: toys, activities, hair, clothes, a certain aesthetic upon which effectively the (self) diagnosis of trans is made, and a social role transition affected. Unfortunately these tropes are compounded and perpetuated by some “diversity” trainings delivered in schools.
We have also witnessed a coincidence of autistic spectrum conditions and gendered/ sexed distress. The lens of gender can seem very apt for these girls retrospectively to understand their difficulties: always feeling weird, not fitting in, struggling to understand social interactions and cues, bullied often, feeling themselves to be outside the norm. Additionally girls struggle physically with puberty; as a change from the familiar, often unpredictable, body sprouting and changing, unwanted thoughts and feelings.
The distress of their body seems to accrue over time for these young females; it was not primary. Socially transitioning might even have an iatrogenic effect on gender dysphoria as the body becomes a shameful secret that needs to be disavowed – we see embodied disconnection and alienation snowball. We are now hearing first hand from detransitioners that, had they not found this relatively novel way of understanding their difficulties (inevitably with the assistance of the internet) through the explanation of ‘trans’, the natural history would suggest they would find themselves living as lesbians. Furthermore, how they looked, lived and loved needed no apology.
In summary, in the clinic we witness this toxic collision of factors: a world telling these children they are ‘wrong’; they are not doing girlhood (or boyhood) correctly. They realise their nascent sexual desire is going to be problematic; they struggle in puberty because it is uncomfortable, weird and unpredictable (particularly heightened if they happen to be on the autistic spectrum).
In all of our good-willed attempts to be empathetic, to share the pain of these very young people, we adults must not lose sight of the risk of joining too closely with them. Their pain is real, their way of making sense of it may be helpful, but it may not. Adults and professionals have a duty to step back from the feelings, whether their own or the young people’s, in order to consider what is fundamentally in young people’s interests. Listening can occur at many levels. We can hear and respond to distress without agreeing with the other person’s explanation of why they are experiencing it.
The significant treatment decisions being made are adult decisions. It is simply not possible for a child or adolescent to conceptualise a loss of fertility or sexual pleasure before they have developed their adult body."
(continues)
womansplaceuk.org/2020/02/17/the-natal-female-question/