Healthcare in America is extremely difficult especially when you fall under the trans umbrella. And that is if the trans individual is even given any form of healthcare. Doctors have been able to discriminate against LGBTQ+ people.
Surgeries and hormones can be life saving and restricting that necessity creates it to where their only option is to get non prescription hormones. It’s been reported that 1 in 10 transgender Americans use hormones that havent been prescribed by a medical professional.
Doctors need to be informed about the spectrum of patients that they will have in their career. Gender affirming and neutral language can be a step in the right direction. As well as asking for a preferred name and pronouns and introducing yourself can help break the ice.