The Standards of Care V7 has a section on Informed Consent, on pages 35-36, and page 28 says "Psychotherapy Is Not an Absolute Requirement for Hormone Therapy and Surgery". The entire document is worth reading.
If you're crazy you may not be capable of giving informed consent, and judging this is the expertise of a psychiatrist, not a doctor. I'd imagine the doctor also wants to pass of the legal responsibility to someone else.
I don't think the doctor has and legal obligation to treat you, but perhaps you could try a harm minimization argument - you've no money for a psychiatrist right now and losing the hormones will cause you harm. Of course you'll do it as soon as possible.