I guess I'm just now realizing it after reading the trouble people are going through, but all I did to get hormones is I called up the local lgbt center and asked for an lgbt friendly doctor. Called him, made an appointment, got anti androgen a month later and hormones a month after that. Tests blood once a month to check levels and liver functioning.
No letter or anything.
Did I just really luck out? I'm sad to see my brothers and sisters having hard times with this crucial step in transitioning.