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The problem is, trans people are very vocal about this, people don’t want to listen! I see so many comments about chopping dicks off - that’s not even how bottom surgery works.
Trying to “decouple” does nothing, because these people are going to be deliberately disingenuous. Notice how all often the news headline is “judge bans sex change surgery for youth” - it’s a lie, and it’s on purpose.
The reality is that gender affirming care is mostly hormones. Bottom surgery is prohibitively expensive and rarely covered by insurance. Rarely I’ve heard of teens having breast reductions, but it’s also 100% legal and accepted to get a cisgender 16 year old a breast enhancement.
I don't think they are. I never read or hear anything about gender affirming care being limited to things that are reversible. It's a deliberate euphemism that can be used for anything. If the fight isn't about irreversible changes, why not separate the two so at least one can get accepted?
I'm personally against the breast enhancements for children that you mention as well, but in that case I think it's generally accepted as tattoo's are: with permission from the parents and not paid by the public.