That is so GREAT!
For what it's worth, I just got back from my new primary care physician to whom I was referred by my now former primary care physician in the same office. My new doctor seems to be the specialist in the office about Transgender Patients. It was just all about "Informed Consent", and an upcoming phone conversation with a Gender Specialist Social Worker in my health insurance plan. Then I will be good to go for HRT!
Oops!, one other problem. I have an issue of borderline high blood pressure that my primary care physician wants to get in check, possibly with medication. Remember that I am 64 years young and beautiful but I need to make sure my old person health issues are good to go before I can get the wonderful Estrogen that I crave so much.
No "Letter", just "Informed Consent with a conversation with a social worker", but darn it. I need to have my blood pressure within parameters before my really cool new doctor gives me the green light to HRT.