Technically therapy isn't required anywhere. It's just a matter of whether or not there are informed consent options near you. If there are, you can skip therapy and start HRT immediately or with a short wait. If they want you to speak to a therapist first based on your screening, they may refer you to someone.
There are online options you could consider as well. They were roughly $50 per session and it is about as detached from therapy as you can be while still being in therapy.