Then you have transgender activists routinely attacking people in their own community who regret the surgery, and papering over the inconvenient truths about hormone blocking drugs (they cause permanent bone damage in children).

I'm not taken by arguments that routinely include tactics like death threats towards campaigners who speak out against dangerous hormone blocking drugs.

It isn't "completely ineffective", there is a solid evidence base that people who want it and get it are happier than people who want it and don't.

> at preventing massive suicide rates

A large part of suicide rates is hostility from society. For example, what if society forces people who don't want surgery to get it just to update their IDs? This is a eugenicist human rights violation, and it was the case in Sweden for the time period studied.

Note that in the time period, Sweden also required trans people to prove that they didn't have any gametes in storage! This was such an egregious instance of eugenics that the Swedish government should be paying millions of USD in reparations to anyone affected.

> why is it an option?

Because it works and makes people happier.

> Post-op transgender people still have extremely elevated suicide rates

Due to hostility from society. Suicidal ideation and behavior is a well-known component of CPTSD, and almost every trans person I know has CPTSD from social hostility. (There is one trans person I know who doesn't -- she's 20 and grew up in a supportive, left-wing environment.) That doesn't reflect on any kind of surgery. Rather, it's a damning indictment of society.

> therefore the surgery is ineffective.

False. This absolutely does not follow either logically or empirically.

> Then you have transgender activists routinely attacking people in their own community who regret the surgery

First off, there is not just one "the surgery". Saying that just exposes your ignorance on the subject matter. (And you really should spend a few weeks learning about trans healthcare before commenting any further.)

Besides, your claim is false. The objections are only to the people who regret it and use that as an excuse to attack trans healthcare generally. I know trans people who were forced into a surgery they didn't want, regret it, and everyone I know has full compassion for them.

> and papering over the inconvenient truths about hormone blocking drugs (they cause permanent bone damage in children).

This is a well-known side effect of low sex hormones (also happens in post-menopausal women). There are also serious side effects to not intervening. As always, you have to balance the benefits with the costs of intervening versus non-intervening.

> I'm not taken by arguments that routinely include tactics like death threats towards campaigners who speak out against dangerous hormone blocking drugs.

Plenty of medications have side effects. Accutane can cause depression. Hormonal birth control can have serious side effects. Focusing on this over anything else shows your biases.

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If you're engaging in good faith and would seriously like to learn more about trans healthcare, https://medicine.yale.edu/lgbtqi/research/gender-affirming-c... is a good starting point. There are over a hundred citations in the paper, and you can use any of them as a starting point. Sci-hub is your friend.