I think based on others comments and experience's that the system is not perfect by any means, even after RLE and all the gate-keeping etc people can still have regret, however that can sometime be due to incorrect method of therapy, or mal-practice of doctors in general and their loose interpretation of guideline's.
I personally don't understand the whole RLE experience, mostly because I went at it do or die, meaning that I was going to be the proper gender or I was going to not exist anymore (suicide). I accepted the possibility of people being negative, loosing family and friends and even starting over from 0 because I viewed it as preferable to death or worse living as male, when srs took place similier decision was made, and I had surgery but what was right or worked for me should not be used as an example or as a "proof" to proper treatment and therefore shouldn't be forced on someone because what worked for me may not be ideal or work for someone else.
If anything, treatment should be tier based that is start with the less permanent treatment and go from there, hormones/RLE, than surgeries is so desired, again at the option and choice of the individual and not the doctor or therapist.