 so i've always had the standard surgery is something that is a much higher medical standard and that should be reserved for adults uh for a variety of reasons for once it is fully permanent it's unchangeable but also it requires you to undergo anesthesia all sorts of recovery time like that's a much larger decision to make when it comes to other gender affirming therapies i am somebody who is not you know i'm not a medical expert i don't think most members of congress or most bureaucrats are either i'm inclined to let that very personal decision very rare decision we have to remember