Hi, I'm relatively new to Susan's, I've had my account for a while but I don't post often

I identify as non-binary which seems to be proving difficult when it comes to a physical transition. I am going to pursue top surgery, it's just how to do it. I know I can go the informed consent route but I do like other surgeons who require letters of recommendations.
I don't really know what letters of recommendations involve exactly, whether I have to see a gender identity specialized service or I can just see a psychiatrist familiar with lgbt issues? can anybody offer me some help here if you had to have these referrals or are currently going through the process?
I'd have to wait up to a year or more to get an initial appointment with an NHS service, I know there is a private clinic in London which I am considering but it is going to be expensive for me, they have told me I would need 3 appointments which are costly and the travel expenses are also very costly and I don't even think I'd be guaranteed to get a referral with being non-binary.
Thanks for any feedback any one can offer me it is much appreciated