Secret third option: all medical care, including gender affirming, should be collectively funded. That includes gender affirming care for cis people like breast enhancement and Viagra. Problem solved.

Those procedures aren't "gender affirming care" in the sense as is used for treatment of gender dysphoria, though. A man who takes viagra to mitigate erectile dysfunction, or a woman who gets breast implants for either reconstructive or cosmetic reasons, isn't doing so because they want to mimic the appearance of opposite sex. Which is what the euphemism of "gender affirming care" actually means in its original context, as it is applied to trans-identifying people. Let's not pretend that these are the same type of thing.