Gender affirmation only counts to them if it defies the sex or gender binary. They’re completely fine with people modifying their bodies to affirm their masculinity or femininity so long as they were assigned male or female at birth accordingly.

Trans people pursuing medical transition are such a small percentage of the population that cis people getting hormone therapy or affirming surgeries will always dwarf the number of trans people who are. Throw in all of the ways we affirm the gender of cis people, through language and fashion and culture and so on, and it’s evident what their gripe is. It’s never been about children receiving gender affirmation, merely their conviction that transgender people do not exist or are immoral and evil and shouldn’t exist. There’s a reason modern transphobia is highly intertwined with fascism. To believe that an entire group of people, based solely on their gender, is immoral and evil is only possible through a lense of dehumanization and conspiracy. Something they are especially good at. We are too few in number and too disparate to counteract the efforts of fascists, who by themselves outnumber us in every way.