The NHS has a three-tier referral system for accessing the gender clinics. Basically, you go to your GP, GP refers you to a local mental health professional, and that specialist then refers you to the clinic.

My GP, though, wanted to know: Does she refer me to a psychologist or a psychiatrist? I would think the second tier wouldn't need to be able to prescribe meds as they would really just be a waystation... am I missing a critical point here though...

I would think that a psychiatrist would not prescribe hormones just refer you to an endo with a letter. A psychiatrist would more likely prescribe depression drugs that do not need physical monitoring.