It shouldn't even be 18. 21 is when you're fully developed, and that's when I feel like this would be a safe choice to start surgical and hormonal treatments

Some say your brain is not done developing until age 25, but people start having kids at 18. Like most medical treatments it is between a person and their doctor. Currently the status quo is at least three months of therapy, two signed letters from a therapist and a psychiatrist and one signed letter from a pediatrician that the kid needs the treatment. Does that not sound like more than enough documents?