If I'd had my druthers, I'd have done it a lot faster. My wife was on board and supportive from day 1, so that was not a concern.
My delays have been due to the health care system. Waiting lists are crazy, due to a shortage of doctors. I went private for a couple of my therapist letters just to speed things along.
Getting my second GRS letter took more than a year. It had to be from a psychiatrist, so I had to work within the system. By the time I was six months on HRT, I knew I wanted surgery, so I asked my doctor to get me started on that process. She referred me to an out of town psychiatrist whose waiting list was "only" a year. Most have two-year waiting lists.
I waited patiently for 12 months, then decided to rattle the shrink's cage. When I talked to her secretary, I was told it might be another year. Fortunately, the doc took pity on me, and got me an appointment with a month (i.e. 13 months from referral). The appointment was a big anticlimax. Three and a half hours driving each way, for a half-hour appointment! It took another two months to actually get the letter in my hand.
And that is considered fast around here! Then I had to wait for insurance pre-approval. Now I am waiting for a surgery date.
If it was up to me, I'd have had my surgery more than a year ago.