Could you explain what you mean by gender affirming care for cis people, @TiredoftheRhetoric ? Do you mean cosmetic surgery and other cosmetic interventions? and are you therefore equating gender reassignment medical interventions with cosmetic interventions?
That is interesting in itself. But, additionally, it is worth mentioning that cosmetic interventions (for the people you call cis) wouldn't generally be considered ethical if they produced the same level of risk, lifelong medicalisation and adverse health outcomes that PBs are associated with. Additionally, very many people think they can be unethical even with a relatively low level of risk
If you don't mean cosmetic interventions, can you clarify what you do mean? I can think of medical procedures that are intended to rectify or mitigate specific disorders, and which may additionally have the effect of changing aspects of presentation in ways that are 'gender aligned', but I can't think of instances where such procedures are carried out for the purpose of gender affirmation.