For years I wondered why do I need approval from two therapist for gender reassignment surgery and at times really aggravated me to no end but once I started it all became clear. You see, feeling trapped in the wrong physical body can taunt and consume a person to various states of mind that can lead to a dark place thus never seeing the reasoning behind the "why" behind the requirement for therapy coupled with living in the opposite gender for at least one year.
Here is the deal, feeling trapped in the wrong physical body there can be relief by wearing clothing of the opposite gender but that is usually hindered as many don't have a safe haven to wear clothing for an extended period of time and eventually as one grows older the feelings of being in the wrong physical body become more intense and can destroy marriages and cause one to become secluded to the point they are alone and now in their free time can become the female they should be to a limited degree by dressing in the role of a female for longer periods.
The danger here is we think that by setting an appointment for reassignment surgery with an informed consent is all one should need. There lays the problem, it's a completely different world living as a female 24/7 in each and every aspect of your life. It quickly becomes real when you are paying for something in a store and need to use your credit card that says John Smith when you are dressed female. You might get lucky as I did, sales lady looks at the name on my credit card and says, John Smith is your husband? I will need to see your identification. Me, no that is my name, sales lady, your parents have a strange way of naming their daughter. But not everyone will be fortunate for this to happen. Next up (which should had been firsts).
The female voice, a dead give away if not practiced. You are paying for groceries at the store, cashier engages you in conversation and although nobody would every guess that you were not female because you have taken the time to dress properly, age appropriate clothing and not to much makeup you say something and out slips the male voice, oooops, you get the idea.
In the real live experience you are under pressure either all the time or some of the time and for many will truly challenge their original thoughts of transitioning. Geez, can I really pull this off? What I mean is, once you have a vagina and breast it's a completely new world and you have no choice but to either blend in as part of the scenery, become part of the scenery or become ostracized for being a freak and with that comes depression, self-doubt or more leading to dark places OR you rise to the task of merging your inner female self with a new physical self from the affects of hormones.
Trust me when I say, you have no idea, no clue what one year of living in the opposite gender is like until you have been doing it for say three months and then look back 12 months later and can't hardly remember what it was like as a male and if you can more likely than not remember it differently how the full time female experience would be.
I challenge those taking this journey to write down their thoughts before starting HRT and therapy then say 10 months down the road read what you wrote and see how you think about the journey now. If comfortable, keep a daily journal of your ups and downs, like anybody living we have ups and downs and in the 12 month role they are magnified. When seeing a therapist there are gaps of time between visits and having these notes can help you engage with the therapist.
BOTTOM LINE: The real life experience as I see it now is that it's good for you while looking back I thought "what the heck".
Hopefully those traveling down the road for gender reassignment surgery will be fortunate to have a good support system in place to assist them with the 12 month real life test and it will go better this way. Personally I had (and still have) a wonderful female friend who not only supported me but traveled to California to be with me for GRS and then with breast augmentation was there for me too in my home taking care of me. You can not do this on your own, I repeat, you can not do this on your own so get use to the fact you will need a good support system which should be done before starting your journey, find out who are really friends and who are not and don't be surprised that many may be repulsed at the thought of you wanting to be female.
I was just scanning over the following page and saw that some people are asked to wait up to two years before being given HRT, that is outrageous. I think that HRT and real life test should be allowed together.