Is this person asking to substitute academic rigor with public opinion?

From here:

If "gender-affirming care" is so good, the activists and doctors who promote it—and profit from it—should defend their practices in the realm public opinion. In a democracy, everyone gets to weigh in on important issues, not just regime-approved apparatchiks.

Medical health shouldn't be determined by public opinion. It is determined by the data. But then he argues in bad faith so his opinion is invalid to begin with, especially when he refuses to look at the evidence.

I do see a problem with what this person has written. "Everyone gets to weigh in on important issues" is the problem. No, everyone doesn't. Billy-bob, the truck driver from Arkansas doesn't get to weigh in on the effectiveness of the latest cancer treatments and what should be offered in hospitals.

It is also important for the medical and professional communities to "defend their practices in the realm of public opinion." Without this, trust in our institutions and medical community wanes, or at worst, is lost.

If we take a deeper dive into the philosophical issues involved, we can look at how social and behavioral issues that may benefit an individual can be a detriment to a community (or group) at large. For example, if we can make pedophiles feel better about themselves by being accepting of pedophilia, and we can show scientifically that this is the case, the larger question on how this affects society is ignored, therefore, seems unjust that society (or "public opinion") would not have a say in the matter. Granted, I use pedophilia as an extreme example to make the point clear. There are many who question the social and behavioral recommendations of the institutions based on how these affect society at large*. Perhaps this is what is trying to be communicated.

*Don't ask me to provide examples of how trans people hurt society at large. I don't support any of these arguments being made but I know they exist.

To me, this looks like, among other things, the Fallacy of the False Alternative. It is pitching the “activists and doctors who promote it” against “everyone gets to weigh in.” There are other positions to take. Such as it is an issue between physician and patient—assuming the patient is an adult.

If the patient is a minor, then the rules need to be different because children do not have the brain development (maturity) or the experience to make a proper decision. Which brings up the question of who should be permitted to make decisions for them and under what circumstances? This is a question beyond the scope of the question presented here.