My insurance company requires following the WPATH guidelines for surgical transition. Which means one gating factor is securing two letters from different mental health professionals, recommending you as a good candidate for top or bottom surgery, with sufficient dysphoria to make surgery a medical necessity. I have already seen those people and gotten their verbal approval. Today I got to pick up the first of the two actual letters, to take to my doctor for my files. Once I have the second one, he can contact the surgeon and get me into the waiting queue for my surgeries. I should have that second letter soon!