I am fortunate enough to live in an area where it is possible to transition, and am thus placed in an incredible position of privilege compared to the majority of trans people worldwide. And yet even from this pinnacle placement, the healthcare I, and many like me, receive is completely disgraceful.
I have had life saving medication dangled over my head while being forced to conform to my doctor's expectations of how and when I should socially transition. I was told that I would not receive HRT unless I came out as trans in a workplace where I did not feel secure or safe transitioning until backed up by medical transition. I was forced to choose between at best risking my livelihood, at worst risking my physical safety, or not recieving the medication. The prospect of the medication was only thing stopping me from killing myself, like many people suffering the mental and physical pain of dysphoria and marginalization.
My partner has been sexually harassed by a doctor while trying to get him to assist in the process of seeking surgery. Even the very best doctors know almost nothing about trans issues, and the best we can generally expect is "I'm willing to listen to you - teach me". We cannot rely on doctors to help us.
And again, this is the very pinnacle of fortune for a trans person. It's disgraceful.