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I don't think that very young kids should be assumed to have a stable gender identity. Children need a lot of room for make-believe & role play; boys may play girls, girls may play boys. But gender dysphoria can manifest early, and that's a separate issue from the best response.
For all my concerns about medical transition, I desperately wish the world would be a bit more chill about kids trying on various hats, and just let them work through whatever they want to work through via play & role adoption without either punishing or endorsing it
I don't wish to personally mediate the hard decisions that have to be made when puberty comes up, but lifelong fertility is on the line at that point and kids do need to understand that it's very hard to predict how much that'll matter later in life when you're 11, 12, 13
Likewise, it's becoming easier to "pass" later in life, but it's still the case that medical transition earlier produces better results. I think it's reasonable to prioritize both delay for fertility preservation in childhood & fairly early transition for long-term dysphoria
But frankly, if teens are going to be making decisions of this caliber for themselves, it can't be the first time. They need to have some experience with making important personal decisions outside the sheath of parental oversight much earlier on
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