It seems really strange that $\pm$ can be eliminated, as an algebraic manipulation... it doesn't seem like an algebraic rule.
I think it's as simple as, if $x\ge0$, then $x = \sqrt{x^2}$, and if $x\le0$, then $x = -\sqrt{x^2}$, so we don't need the gosh-I-don't-know $\pm$, but this doesn't really make sense to me.
Just for context, this came up in trig. I worked out the derivation, but am puzzled at the step in the title.
\begin{align} \tan \frac{\theta}{2} &= \pm \sqrt{\frac{1-\cos\theta}{1+\cos\theta}}\\ &= \frac{1-\cos\theta}{\sin\theta} \end{align}
I'm missing something more basic than trig, but I don't recall this ever coming up before. Thanks for any clarity!