“… The “dirty secret” of the insurance industry is that most denials can be successfully appealed…”
It’s about risk.
I don’t think many people are seriously suggesting banning gender affirming surgery, I certainly am not.
But to your point; yes it would be better if more thought, research, alternatives and wholistic health was put into LASIK, or alcohol, or even just food.
Both individuals and society would benefit, which is why many governments make medicine essentially free.