Sorry this is way late, but it's not archived so I hope I'm not breaking any rules.
I was never diagnosed with gender dysphoria. I did have pre-existing mental illness, so I asked my regular therapist for a hormone letter. She had been seeing me once a week for years and we had discussed gender issues a lot so I felt like she'd be happy to help me become a whole person. She said yes when I asked but the following week she told me that her agency "doesn't do that." I felt betrayed and I got angry and asked for the contact information for her supervisor. I told her not giving me a letter was just weird transphobic bureaucratic theism, and she talked to her boss and her boss told her to write the letter. She gave me the letter and told me never to come back because their other clients were christians and it wouldn't be safe for people like me to be there. I had actually cared a lot about the people there. They were my friends. My kid was friends with their kids. She didn't even give me the dignity of calling me transgender. She thought I was a confused lesbian and that's what she told people. The letter she gave me was ridiculous. It was very bold and clear about how I was a good woman who wants to someday be a man. Luckily my physician had also been seeing me for awhile so she only needed the letter as a formality.