Informed consent is kind of a new thing; the therapist as gatekeeper model has nearly 50 years of inertia behind it. Not many doctors do informed consent, but they're out there. It sounds like the limiting factor is your insurance, not necessarily the availability of a doctor.
My friend did live as female and is in every way 100% girl. But she thought that if the therapists saw her as having any masculine traits, they'd deny her surgery, so she femme'd it up for them. So even though she liked wearing jeans and sneakers, she wore skirts and dress sandals when seeing doctors. She also didn't tell them that she liked sports or any other typically male activities because she was afraid they'd say she wasn't female enough, even though she just happens to be a girl who likes some activities associated with boys.