:: sigh :: I know it sounds harsh, but this is why I say caveat emptor.
No matter what anyone does, if someone is hellbent on having surgery, for whatever reason, they will jump through the correct hoops to do so.
I personally feel that it is ridiculous for 1% of the patients to control the process for the other 99% that have their head in the right place. Especially since these 1% are going to do it their way no matter what.
Which is why I advocate that the surgery is between the surgeon and the patient. If the patient signs a release form, they are done, and the surgeon is not responsible. They [surgeons] are there to help people, but they can't be responsible for people that will lie to get their way.
I agree that people should seek out therapeutic help if they are under stress, and someone seeking to transition their gender would qualify. But this onus that was created for the therapist to act as a gatekeeper is to me, an outdated notion -- well-meaning, but pointless.
I think that therapists need to get back into the business of helping people deal with taking responsibility for their own actions, and out of the business of trying to manipuate people into a certain course of action.
Maybe, just maybe if that power were removed from them, than people coming into a therapists office would feel free to discuss their issues rather than telling whatever story was needed to obtain the service they desire. In essence, giving people more freedom and control over their behaviour could engender an environment, where a therapist could help a person discover that the issue(s) motivating them to feel compelled to obtain GRS or whatever, will not help them solve the issue. I don't feel that the current climate, somewhat adverserial, and definitely coersive, does anything to help the 1% from obtaining said GRS or other surgery anyway. Freedom is needed to develop a bond of trust, and if a person feels constrained from talking about issues out of fear of losing access to their compulsion, than nothing has been gained. That person will surely lie, because they have so much to lose, in their own mind.
Remove the barrier, and that person now has the freedom to actually talk freely to their therapist.
It may sound silly, and it may be contrary to everything everyone has been taught, but from my POV, the system isn't doing anything to help the situation as it is now. And we all know that the definition for insanity is to do the same thing over and over while expecting a different result. Even if this does nothing to help the 1% people, at least it has freed up the actions of the other 99%. And who here, if PO, would not have chosen to have corrective surgery at the getgo were it available? I can tell you what all the people I've known would say unanimously -- if I was going to do it anyway, why not get it out of the way, so as to focus on lifeskills instead of worrying about when or if surgery will become available.
To me, it like my Mother's theory on kids and candy. The more you restrict it, the more valuable it becomes. So, she used to place candy out in the middle of the table for any of us to grab what we wanted, when we wanted it. It was there, 24/7, twelve months per year.
Did we stuff ourselves with candy? No. We barely thought about it. It was just there. I think perhaps if surgery were removed from the holy grail of trassexualism, than the compulsion to have surgery might lessen as well.