That's mainly the case with the NHS here in the UK as well. They usually require around 6 months RLE before they'll prescribe. At the end of the day they are, in their minds, protecting both the patient and themselves. They are basically looking for some evidence that you are committed and that you can adjust comfortably to a new gender role. I'm not saying that's always the right way, it's just the way they operate.
I knew this was the way things were done so I just went full time when I thought the time was right. I had to wear a wig, I didnt look very good, but at least I was moving forwards, and I'm actually really glad I did it now. If I'd been waiting for hormones to make me actually look better, I'd still be a miserable guy right now.