Let’s say I, a middle aged cis man went to my doctor, wanting gender affirming care, and my doctor wanted to provide - what, if anything, would the treatment/care consist of? Just making sure my testosterone level was up to Hegseth-approved standards?
The difference is that one has gender dysphoria, the other does not. So although the operation is the same, it is not gender affirming care, because gender affirming care is by definition for people with gender dysphoria.