and my cis, straight, femme, heteronormative therapist gave me my hormone letter after my first visit. I had very few token hoops to jump through. But like others have said, my god, RLE was such a blessed relief to me that I immediately knew I would never, ever go back. In the big scheme of things, it wasn't a hardship, rather I thrived on it and knew it was what I had needed my whole life.
Speaking as a post-operative woman, I know I personally would be very strict. That's because as much as I know without a doubt and still feel that surgery was the absolute right choice for me, I also see it as a drastic, desperate measure to be cured. I mean let's face it; once ol' Humpty Dumpty's been sliced and diced, turned inside out and shoved back up a hole in your crotch and your testicles incinerated, all the king's horses and all the kings men... well, you get the idea.
My surgeon is a post-operative woman herself. She was very adamant about both the RLE requirement and the 2 therapist's letters which had to be by the SoC book. Personally to me it was a very minor thing to fulfill the requirements; that time was fleeting and passed before I knew it, and now I will never again have to live up to anyone else's standards just to be myself. But I'm a firm believer in the Standards.
As for these threads here where people are saying they're not sure about it, I would say... it hurts like bloody hell.

And then there's the risk you may end up with no feeling at all, and never have another orgasm the rest of your life. Of course if you have the surgery and then later decide it wasn't for you, well, it's too late then. It is permanently permanent and irreversible. There is no going back, which to me is one of the most wonderful things about it and one of its most attractive features. But if that thought scares you, then you aren't ready.
Never mind that it is a cure that has worked for thousands. Never mind that to most, the results of female SRS are indistinguishable from original equipment. Never mind that the peace and rightness of being I experience now is like something I never could have even dreamed possible before surgery. Never mind all that, because none of that stuff matters at all if it is not the one and only thing in
your life personally that is going to cure your GID and let you get on with your life.
Surgery is not for everyone. It is a last resort when all else fails, and anyone who goes under the knife had better be very sure of themselves, be very sure of the risks and possible rewards, and have realistic expectations of the results. My own expectations were far exceeded, but by its nature it is an experience that is non-transferable to anyone who hasn't been there. It's a risk. If you're doing it for anything less than absolute necessity, then again, you aren't ready.
I admit my motives are selfish. Every person who wrongly chooses SRS and later regrets it is just another Charles Kane, someone whose experience will be flaunted back to us as "proof" that everything we say about the transsexual condition is a lie.
so anyway yeah, it's probably a good idea I'm not in charge of these decisions lol