During puberty, it's just puberty blockers to delay as long as possible and gain more time for therapy. These are a conservative treatment, the absolute minimum intervention that allows the child the opportunity to be assessed further without putting them through unnecessary distress.

Between 14-16, HRT may be started if everyone, including mental health professionals, are sure that this is what is right for the patient.

Surgery is a minimum of two years after starting HRT. So the vast majority of those procedures will be done on patients over the age of 18. And the patient will have had to maintain their transgender identity for a solid two years, while under the effects of HRT and probably living as their gender full time. In the rare case that a patient somehow begins to transition mistakenly, they have a minimum of two years, watching their body gradually change, to bail out.

After all those checks and balances, it's really no surprise that transition regret is very rare.

as if they arent on the payroll here too? C’mon.

I'm sorry, but I don't subscribe to wild conspiracy theories that the entire medical profession, including basically every major medical body around the world, are all colluding on the subject of transgender health and taking enormous reputational risk, to forcibly "trans" a tiny handful of people.

There is simply not even close to enough money in it.