Your experience is the one that is a bit more unusual. The vast majority of mainstream practitioners follow the WPATH standards for obvious reasons. It is the conservative approach. You frequently complain about the stops and starts and frustration that has caused you in your care. Based on my experience, you have had it relatively easy. Most of the people I know had to go through much more elaborate hoops than you did. In Florida, I had to meet with an LCSW twice a week for three months just to get a referral for HRT. But then that is Florida. Probably not dissimilar to Utah.

Many people chafe at anything they view as gatekeeping because it makes it more difficult for them to just do what they want, when they want to. I have been part of this community for a long time. While I understand the concerns of many, I have also observed that there are any number of confused people out there who are not really trans and are struggling with other mental health issues which are often the real problem or at a minimum are co-morbidities which also need to be addressed. A common one is gay men who are homophobic. It is not uncommon for them to take on a trans identity as a way of dealing with their self loathing. They are not really trans; they need to accept their true identity and sexuality.

The last thing anyone wants to do is to perform irreversible procedures on someone who actually has an unrelated mental health problem. Moving cautiously after full and thorough evaluation is actually a good thing. The key is to keep the review process reasonable and avoid making it so onerous that it effectively blocks care for those who need it. The system may not be perfect, but it works a lot better than some of the alternatives people are pushing, which is why It is being continuously tweaked.