The answer
An evidence grade never makes the policy decision by itself. The decision also depends on the severity of the condition, available alternatives, reversibility, developmental capacity, known and unknown harms, and the cost of being wrong.
Medical transition is not physically neutral: blockers suppress normal puberty, cross-sex hormones redirect healthy sex development, and surgeries alter or remove healthy tissue. When the claimed psychological benefit is uncertain but the bodily intervention is certain, the ethical threshold has not been met.