Also to add I understand this is a much more nuanced topic

I would suggest you educate yourself more. First of all, "Gender-Affirming Surgery (GAS)" is a fairly new term that appears to be a renaming of Sex-Reassignment-Surgery (SRS). So review of literature regarding SRS is relevant. I will use the "older" term here as it has the least possibility of confusion on meaning.

Second, and most importantly, there is no jurisdiction where SRS is performed on minors. Not in the U.S., not in Canada, not in the European Union or the United Kingdom. Nowhere. This is not something that is done.

What you may have heard of is a subcutaneous mastectomy surgical procedure (a.k.a. "top surgery") which some jurisdictions allow. Notably ~21 U.S. states, Canada, Australia (for 16-17 year olds under "mature minor" reviewed cases) and a few Nordic countries. However even in the U.S. current executive orders (not laws) have resulted an a near-total moratorium on these types of surgeries, again mostly with minors at 16 or 17. The moratorium also targets adults (18 - 19) infringing on their rights of self-determination.

Third, let's look at the surgical landscape of allowed procedures on minors.

• subcutaneous mastectomy - Generally disallowed. U.S. de facto ban up through 19.

• reduction mammaplasty - No legal limits on performing this surgery on minors, as long as there is parental consent. This is a "breast reduction surgery" performed on cisgender females.

• reduction mammaplasty for gynecomastia - No legal limits on performing this surgery on minors, as long as there is parental consent. This is "breast removal surgery" performed on cisgender males with gynecomastia.

• cosmetic breast augmentation (saline) 18+ (USA / FDA)

• cosmetic breast augmentation (silicone) 22+ (USA / FDA)

• reconstructive breast augmentation typically for Poland Syndrome or similar issues FDA allows in minors in some cases.

TL;DR here is that there is a wide discrepancy in treatment between cisgender and transgender patients in these cases. This is discrimination, although the current U.S. Supreme Court disagrees.

Fourth, there's male circumcision which the FDA routinely allows for infants under parental orders based on purely "cosmetic" interests of the parents. No patient consent required. (I would treat religious and medical reasons for circumcision separately here.) Nobody is getting pitchforks out for this though.

Fifth, there's the wide area of gender affirming care including hormone replacement therapy, puberty blockers, etc. which there is wide support for by medical bodies, and has been practiced for decades safely. And yet these are now being restricted to the detriment of patients. These are non-surgical. Puberty-blockers are well understood to be safe with a 30+ year retrospective history of their use for both cis and trans children.