Going back to the OP, there are some interesting bits of information.
When the whole C-section by choice for mental health/ other reasons came about there's a few very neglected point.
For years EMCS and ELCS had been conflated into one which massively distorted the methodology. For starters when you attempt a VB one of the possible outcome is an EMCS. But the data relating to EMCS was always isolated from VBs. Equally when you studied a planned ELCS separately from a EMCS there were massive differences. An EMCS is considerably more dangerous and ultimately this is the outcome you want to avoid.
These also never looked at harms in terms of mental health and what denying a CS would cause. Or harms in terms of various long term complications.
What was notable though was that affluent middle class white women who were older and educated - and able to make the most informed decision were getting markedly better outcomes - short term, long term, physical and mental - than anyone else. And this is true of pretty much all medical issues. And yet this was the group being smeared and labelled as 'too posh to push'.
Then there's costs. When adding up all the costs for a VB or an CS no one bothered to look at the costs due to complications. This includes mental health. When NICE did this, they concluded that offering ELCS was comparible in cost to the NHS when they factored in urinary incontinence alone - not any other complications. They concluded on this basis they couldn't argue against it. The issue is which budget pot this money comes out of.
They also realised that if enough women have an ELCS you reach a level where that becomes cheaper than attempting VBs. Why? Because it affects staffing costs. Most babies are born in antisocial hours - by scheduling births you could massively reduce the numbers of staff needed to manage an NHS ward. They concluded that this was actually an undesirable outcome because for many women a VB and the choice to have a VB was better. We do see this happening in parts of the world though - China has such a staffing crisis they shifted to this pattern (noting the one child policy as part of this as many of the risks with an ELCS are to do with subsequent births).
On that above mentioned point about subsequent births, given one of the trends in the UK is to have a baby in your late thirties or early fourties and only plan to have an only child this should be something that is considered - this age group is most at risk of EMCS.
Further to this there were deliberate efforts by certain groups to suppress data relating to ELCS. In the 2000 WHO introduced the idea of an optimum level of CS - this lead to many British hospitals trying to keep to this level. Yet it was nothing but an ideological concept and one that data WHO itself produced contradicted. They put this study out which had a conclusion that read that planned VBs were safer than planned ELCS. The data in the rest of the report said no such thing. They were actually pretty comparable with ELCS actually coming out very marginally safer! This was shocking and institutionalised ideology over and above research because those doing the research had an agenda and bias.
Further to this other studies realised that those most at risk of EMCS were much more likely to have a history of anxiety related issues or fear of birth. It is thought to block oxytocin and the progression of labour. So blocking women who were citing these worries was utterly counter productive.
And this is what the older middle class white affluent women who were educated were identifying. A scientific and rational basis for their decision making. They were making informed decisions.
My personal problem with the more to more ELCS is that some of the women doing this aren't informed. You have younger women who want more children making the same decision not realising where the risks are stacked. Many are choosing ELCS out of fear of poor care during labour rather than because of other reasons. This is unacceptable and a comment on the state of maternity care rather than the risks of childbirth.
Compare this with what's happening with kids being transitioned. It's based on what we know to be highly flawed data, measures and ideas. It's being carried out on children lacking capacity. The push for it is coming from ideological groups who have their own agenda and therefore a conflict of interest with the best interests of these children.
The children most at risk are the highly vulnerable. They are not advocating for themselves. We know that children in care are on the front line of this. Outside influences and duress are parr for the course.
And much of the same still applies to young adults.
It is the exact opposite dynamic. And yet it's still underpinned by the same issue: healthcare, particularly involving the care of women, is a target for ideological interference and control. Sexism drives ideology in healthcare. It is institutionally sexist.
Ideological interference does not tend to get involved in mens health care. It's incredibly noticeable.
When ideology mixes with healthcare, scandals occur. There are no exceptions to this rule. It always happens because doctors stop paying attention to science. This always means that women, girls, non-whites, homosexuals and disabled people are always more at risk of being the victim of a medical scandal.
The two subjects: medically transitioning or choosing a CS are sometimes compared as being examples of patient led care. This is fundamentally misleading and flawed.
The data actually shows numerous very compelling reasons why women might legitimately make an informed choice to have an ELCS. The risks are well known and understood and continue to be examined.
When it comes medical transition, most data relates to males, medicalisation in children has massive data suppression issues and is lacking in long term data and information from other associated issues further down the line isn't remotely connected. There are massive consent related issues. There are massive costs from unsuccessful surgery which is common. And ultimately we don't even know if it really works as there isn't much work on detransition issues and we know there are high levels of regret which are being actively suppressed (including suicide related issues post surgery).
They couldn't be more different.
Now this is a comparison I do care about because it very much is about harms to women by the medical profession. But equally my personal circumstances involve both - my parents have tried to make equivalence claims about choice. I've gone one way my sibling has gone the other.
So actually knowing all this IS important and should be talked about because it is driving the support for transition for a lot of people on these false premises and lack of awareness of just how flawed the comparison is. And actually it's girls and women who transition who are particularly at risk precisely because of the invisibility of sex and how it's starting to become apparent that outcomes in females are particularly negative because of when they transition and the treatments being particularly unstudied / studies suppressed.
Women like me who chose an ELCS are being used as a justification to transition children despite a lack of evidence.
You absolutely shouldn't have 'choice' on the NHS if there isn't a robust case to make in terms of scientific basis for that choice. It doesn't matter what the condition. This is not happening.
We fought a battle just over a decade ago to have it recognised just how the evidence and the financial arguments against planned ELCS were deeply flawed and ideologically biased and had to present a medically and financially sound case for why women should be listened to and choices in certain circumstances given precisely because of prejudices and bias from those with ideological agendas.
This is what I expect from any other area of medicine. And yet trans ideology has written rough shot over ethics and evidence. This is not ok.