I had my three months or so of counselling, then the Psychiatrist whom wrote my letter of recommendation... then a couple weeks later I saw my specialist who'd told me to do all that, and I got my prescription! XD
Course, this is New Zealand so other countries might be different. As far as I'm aware, our standards are based from the UK's ones. Uhm, I see no reason why anyone couldn't start T as soon as they've been given the go ahead from their Psyche's.