Hi Rainbow,
All of my contact with my Psychiatrist has been by Skype. This is due to me living about 5 or 6 hours drive away from his practice which is in Wollongong, (Australia). It would mean an overnight stay for me. Also, as far as I know, he is the closest Psychiatrist who deals in gender issues to where I live.
He has been very good, he diagnosed me with Gender Dysphoria at the first meeting. It may have been that I had been self medicating HRT for 18 months before that influenced a quick result. (Please DO NOT self medicate - it is very DANGEROUS - as I found out). He sent a letter to my GP who is supervising my progress, (blood tests, etc..) and I started on (Official) HRT soon after.
At the last Skype interview he said that he supports me in GRS and to find a surgeon and they would start swapping letters. I was stunned because I thought that I would have a massive hurdle to get over but he said,"I have diagnosed you with Gender Dysphoria and you know what you want." I had been doing a lot of research on HRT, GRS, transitioning, the pro's and con's and the potential problems I may experience. Also I have been fairly open about transitioning to many people in my area. (I like this area and I am not shifting because of transitioning). I believe that these factors may have also influenced his decision to support me.
Also I have been seeing a Psychologist/Counselor who deals in gender issues in Canberra. Those sessions have been face to face and very good.
As for having the sessions on Skype, it is a bit strange but you can see each other and it is very much like a normal conversation. He was happy with doing it that way and I certainly was. I don't know what the situation is where you live, (America?), however technology is spreading and becoming more usual every day. There should not be a problem.
Do not worry about the possible reaction of the "Health Professionals", it is their job, particularly if they are dealing in gender issues. If they give you a hard time by becoming moralistic, etc.. go elsewhere. If you are not comfortable with their approach, find another. You are the one you have to look after. I am in the process of deciding whether or not to interview a GRS Surgeon in Sydney, (there is only one) so this is good advice to myself as well.
I hope this is of some use to you and sorry for being a bit rambly.
Good luck and remember, its just another step on the journey
Jen