Puberty blockers are the compromise solution because we know that this is an area that requires moving cautiously. We want to make damned sure, within our ability to do so, before forcing the kid to go through puberty if they have expressed dysphoria. Any puberty.
It's tempting in a triple blind sense to say "well these are two treatments"—and the review attempts this—but if your concern is PHS you know you could just… jump straight to GAHT or prioritize it very early.