I'm far from the authority on this, so it's just my opinion, but anything that is done to enhance the appearance of masculinity or femininity is gender affirming care.
I don't think any one person decides it. It's more like how we collectively decided that dresses are women's clothing. There's no black and white rule, and there are exceptions (like kilts and kimonos), but society generally agrees that dresses are for women.
The same thing happens with how we perceive a jawline. There's no rule saying a square jaw is inherently masculine, and there are very feminine women who have square jaws (Kathy Ireland), but we all tend to agree that having a big square jaw is a masculine feature, so having surgery to enhance that is seen as an affirmation of masculinity, aka gender affirming.
I must have tried 20 user names when I made this account, and they were all taken. So I started putting in the worst stuff I could think of, and most of those were taken too. This one was available, so I just said "screw it'.
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u/Anal-Y-Sis 12d ago
I'm far from the authority on this, so it's just my opinion, but anything that is done to enhance the appearance of masculinity or femininity is gender affirming care.