Why was Michael Jackson allowed to do this, with no letter?

Why is it assumed that anyone can make their own decision about what is best for them, except when it comes to SRS? I have seen botched botox, botched tummy tucks, botched breast augmentation, botched face lifts and other botched plastic surgeries that have left people incredibly disfigured. We have kids getting plastic surgery. Why is it that everyone else can do whatever they want to their bodies and no one seems to care if they are making a mistake?
Why the huge double standard? It is not so much as I disagree with the SOC, as I disagree with the need for them. I have yet to meet a person who said they were denied the right to transition and so they didn't. I have however heard several who were denied and just went and got another Psychiatrist, told them what they wanted to hear, and got the letters.
I also would like to know where all these transsexuals are, that are getting turned away because they don't meet the SOC. I have yet to meet one person that has been prevented from transitioning because of the SOC. So? if it is not stopping anyone, what's the point, other than to make sure we have to spend a lot of money to transition.
I agree, these rules can only be in place to protect the medical community, not from us, but from the far right who thinks God doesn't make mistakes. Nothing else makes any sense, to me.
Love always,
Elizabeth