Unfortunately it still is fairly important at this point to have a therapist. The thought of people actually ending up in the wrong body is horrifying for people to accept and so the sociopolitical climate influences our care and how it works.
Transsexuality is still incorrectly viewed as some kind of mental problem by low information individuals which is delaying the evolution of our care, from how we navigate the system right down to the techniques that are used. Policy makers in politics and mental medical doctor associations are afraid of their potential backlash so things have always been awfully slow to change. For example, SRS was developed in Germany in the 1930s and has evolved little since. As for the system, we're still required to talk to a mental healthcare provider about our medical needs in order to receive care - something that almost no other medical or physical problems require.
I've recently come to the conclusion of all of that and IMO this is it: Therapists are largely necessary for the time being to access medical care. Without them it severely limits your options for medicine and surgery. The average therapist has absolutely no idea how transsexuality works and none of them have the professional expertise in treating anything transgender related. Dosages of hormones? Your primary care doctor and pharmacist. FFS? Your plastic surgeon. SRS? Your urologist/plastic surgeon. Just don't forget that your relationship with a therapist, conserning solely transgender issues, is a formality.
