Pretty sure everyone getting a sex change feels it's a justified decision, or would either of you like to argue that people do that sort of thing without reason?
here is a nice set of equivocations that is probably just a result of scattered thinking rather than disingenuousness, if I'm being charitable-- and I suppose I am. The charity may be a bit backhanded, but I see no alternative that is still charitable.
1)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who have done it, as a matter of historical fact, have justified at the very least to themselves
2)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of prudence and given all the implications those things currently have in our society today, should justify at the very least to themselves.
3)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who have done it, as a matter of historical fact, have (at least generally) had to justify themselves to others.
4)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of ethics and given all the implications those things currently have in our society today, should justify to others.
5)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of prudence in any time and place including a far future in which people could get really weird with their own gender without any necessarily lasting consequence, as a matter of prudence, should justify at least to themselves
6)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of prudence in any time and place including a far future in which people could get really weird with their own gender without any necessarily lasting consequence, as a matter of prudence, should have to justify to others
7)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of prudence in any time and place including a far future in which people could get really weird with their own gender without any necessarily lasting consequence, as a matter of ethics, should justify at least to themselves
8)the use of gender affirming surgery, hormone treatments, clothing style, etc. is a decision that the people who would do it, as a matter of prudence in any time and place including a far future in which people could get really weird with their own gender without any necessarily lasting consequence, as a matter of (including future) historical fact, will have justified at least to themselves
for the record, I think yes, yes, mostly, no, not really, no, no, no, in many or most cases but it is of little consequence
Also, we can multiply all this by including another category other than themselves and the very general "others"-- specifically, medical professionals. Very broadly, I think that medical professionals should be treated like others; their role in such matters should be informational rather than dictatorial.
you are arguing with people who are clearly saying the opposite of a statement like #4 or possibly #6 by trying to make it a gotcha about #1 or #2. This may be clever disingenuousness aimed at people without the inclination to analyze language and all the various possibilities that can be read into a vague phrase. Or it may simply be scattered thinking, the pointing out of which should prompt further reflection. I suppose I'd recommend further reflection in the former case as well, though not of precisely the same kind.