I think it's quite bizarre. My husband is taking pb now for cancer, but the other side of that is he'sworking on a limited lifespan once they stop working, which they will. So not only are the stakes high it will only be for so long.
How anyone cannot see that just because something is appropriate for one scenario, it's not appropriate for others - the only answers it seems to me is that they don't really understand that precocious puberty is rather serious and it's still seen as a matter where there can be some disagreement over whether the medication might be too dangerous.
And they also don't realize - and I think this is the crux of it - that there isn't actually any good evidence that pbs work for kids with gender dysphoria.
In fact, I suspect a lot of them don't really have a clear understanding what they are actually supposed to treat in such children, or what a "trans child" is. They have just accepted this is the treatment. They probably don't realize the extent to which is was just a made up idea some doctor thought would be good for better aesthetic results.