All children go thru identity concerns, and this issue is especially acute during adolescence. We live in a social media world now, so depression in teens over feeling accepted by their peer group (or not) is magnified, over what it was decades ago.
Developmentally, humans seldom know who they really are AND who they AREN'T, until they hit their 40's. It only happens THEN if there've been no serious impediments to their emotional development.
It takes decades of maturation and life experience to truly know ourselves, our likes and dislikes, and our needs and desires. A child or adolescent is incapable of making sound, rational decisions regarding their well-being, and they cannot be circumspect enough at this juncture to have a sense of future repercussions based on immediate, impulsive choices (that's WHY we regard them as CHILDREN!).
Nobody thinks long-term, when they get a tattoo as a youngster. They never consider, how will I feel about this ornamentation on my body, 10, 20 or 40 years from now? Might I regret this choice I'm making TODAY?
So when we're speaking of permanent, lasting alteration to one's body, what's needed (in ALL cases) is psychological intervention to determine the reasons behind one wanting to undergo such radical changes! Christ, even ADULTS are often required to seek counseling prior to enlisting plastic surgeries, if they're seeking a dramatic surgical change to their physical image!
A relative of mine over the course of several decades, has tried virtually EVERYTHING she believed would finally help her feel a sense of contentment, and good about herself. A litany of body alterations including numerous tattoos, body piercings, and (finally) total breast removal and male hormone therapy has been implemented in what has appeared to be a frantic effort to feel "Happy." And trust me, folks~ with the parents she had, happiness would be out of the question.
I speak to this very issue in one or two of my articles about borderline disordered females. Many suffer from body dysmorphia, which is a lot like women who still see themselves as "fat," no matter how much weight they lose, to the extent of being skeletons with mere skin covering their bones.
I have worked in my practice for many years with body dysmorphic individuals. One client years back had gone consistently to a "psychologist" for 18 straight years, yet he saw his mirror reflection as monstrously hideous! Within a year's time, his self-worth and therefore, self-view radically changed with My help, he lost a lot of weight as a result of his newfound, healthy self-image, and went on to be far more discriminating about his relationship choices!
You might regard this metamorphosis as "magical," but it happened because we repaired the 'inside stuff' (his core) so that he could ultimately view his 'outside stuff' very differently.
If you were raised by parents with issues, YOU have issues. In my relative's case, both her/his parents are supremely narcissistic, and her mom has BPD traits (which is why we haven't been close in many years). She was incapable as my older sister, of giving me the slightest bit of care or support throughout our lives, so I withdrew from the relationship (no sense knocking forever on a door that won't open).
Needless to say, her two children have felt maternal neglect profoundly, and have suffered life and relationship consequences due to her lifelong deficits.
Wrapping back around, the astronomical number of "depressed" and desperate children today, has NOTHING to do with having been born in the "wrong body," and EVERYTHING to do with never having been able to feel good enough or lovable, due to faulty parenting.
Put THAT in your demented Democratic mind-vault, and QUIT trying to convince our confused and sad children that if they try this one thing (sexual reassignment surgery) they'll finally be "Happy" ~because it doesn't fucking matter what you do to the OUTSIDE of yourself, if your INSIDES are trapped in despair!