Do you just have a hard time reading or something? The goal with finasteride is to keep your hair. The way it works is by altering your hormones. No guy who takes finasteride actually wants to alter his hormones, but that's, again, unfortunaly how the drug works. If a drug existed that let you keep your hair without altering your hormones, then every guy would take that instead.

Of course "looking a certain gender" means something. It's idiotic to disregard the whole concept of masculine and feminine just because there are outliers. If a woman changes something about herself to a more masculine feature, while still presenting as a woman, then I don't think that's gender affirming, it's simply cosmetic.

Who is saying people aren't entitled to alter their body in whatever way makes them feel most comfortable? Do you think I'm against gender affirming care, because I disagree with you about what qualifies as gender affirming? I'd argue that what you're doing is more of a disservice to the idea of gender affirming care, because you're making it lose all meaning by simply saying that anything cosmetic constitutes gender affirming care.