I try to stay away from controversial conversations but I am chiming in here. I used to think the same, why transitional procedure while they are still young, but seeing someone going through the pain and suffering makes me think now. There is a kid (not Nepali) I know from very conservative family started identifying they/them. Obviously parents pushed back but started taking that kid to therapy and counseling. That kid is very suicidal and suffering a lot. Now, parents are thinking, should we loose our kid or go through transitional procedure. Haven’t gone through the procedure yet but supporting they/them with everything towards the procedure. I think, surgical procedure is the last option after they run out of all other means.