You have to have two letters from mental health professionals, one of which is a psychiatrist. You have to be on HRT for a year. And the consent process at the hospital is extremely lengthy - mine was actually videotaped and took an hour.

So call it ~3 hours total speaking with "medical professionals" (who all pay off their new Mercedes with tranny fees) and one year on HRT (which I doubt most places even require nowadays), and you're all set to cut off your dick and turn your arm skin into a festering wound?

Nothing about that process is extremely lengthy, especially for sure an irreversible and destructive procedure.