It's not "gender affirming care." It is the amputating of perfectly healthy breasts on a girl. It's amputating a normal penis and balls on a boy. It's sterilizing boys and girls. It's giving a boy puberty blockers that stops his penis from growing so that when he is an adult he has a little boy penis. It's creating a fake vagina that doesn't work like a vagina and that the body treats like a wound, tries to close it, requiring it to be dilated every month. It's ensuring a girl can never breast feed. It's ensuring boys and girls, when they become adults, can never have an orgasm. This Frankenstein stuff.
As I stated, it's child abuse. It should be treated like child abuse, which is unlawful.
I have not read Middlesex. What is it about?
Call it what you like but for longer than you might think, gender affirming care is what it has been known as. 'In 1966 the Johns Hopkins Gender Clinic opened; it was one of the first in the US to provide care for transgender individuals, including hormone replacement therapy, surgery, psychological counseling, and other gender affirmative healthcare.' In fact, the underlying practices like gender-affirming surgery and hormone therapy have been evolving for nearly a century. Also, the term refers to a broader range of care for gender dysphoria than what you outlined. It applies to folks of all ages who have gender dysmorphia, not just children.
IMO except is cases of disfigurement, should cosmetic surgery, such as 'nose jobs' and breast implants be preformed on minors, which it can be and sometimes is with parent's approval prior to age 18.
Here is a link to the Wiki synopsis of the novel Middlesex that fairly accurately describes the story.
https://en.wikipedia.org/wiki/Middlesex_(novel). I read it shortly after it was published in 2002. It is a fascinating read, told from the viewpoint of the protagonist, Cal/Calliope Stephanides, who is intersex.