This is what happens when people with opinions are allowed to advise WPATH instead of sticking with evidence and research.
I will never understand why it has been acceptable for trans people to have less evidence supporting their treatment options than anyone else.
That's discrimination - doing real, measurable harm to people because you haven't bothered researching the facts.
The trans community are not an easy patient group, they are fully Dr Googled, usually self medicating and buoyed up by online support before they ever get to GID - patient groups like that are always going to be hard for medics to manage.
Has it been easier just to give them what they want and worry later if it isn't quite "first do no harm?"
Mermaids board is full of people with opinions and no training. Lived experience and patient experts are very important in healthcare - but they are not a substitute for peer reviewed research.