Lie to your doctor when you're asking for HRT. Tell then you've had dysphoria for years even if you haven't, tell then you're a trans woman/trans man even if your gender is more complex than that.
Tell them everything they need to know to prescribe HRT and nothing else.
Your case and claims will be picked apart and examined under a microscope, looking for any reason to say no. So tell them exactly what they need to hear to say yes.
This, 100%. Cis people only care about dysphoria. They don't care about euphoria or happiness or what we want. We need to look, to them, as if we're in agony. Because a trans person that doesn't exist in rot and self-loathing until they get to transition doesn't and cannot exist to them.
So you lie. You lie like a mother. And why? Doctors aren't your friends.
I'm dead fucking serious. As someone that's lived a long life and has never once been able to trust a doctor after getting fucked over and had my faith in them shaken very early on as a kid, it comes easy for me to bullshit doctors. I get, though, why people who've had limited or more positive interactions with doctors might have a different perspective.
People that have had limited or positive interactions with cops might feel the same way about them, and neither category you should ever, ever, ever, ever, EVER trust.
If it ain't on paper you got nothing to confess. Don't sign anything without having it checked over rigorously. Act like you belong, keep your mouth shut unless it's important, and when they accuse you of something, you get a lawyer.
Some doctors are good, but don't be nice just because there's a 1% of chance of whoever you're talking to be a unicorn. Doctors are not on gay/queer/trans/nb/intersex people's sides and never have been. They enable and perpetuate abuse against us, so you owe them nothing. Spin them a sob story they can't refuse. Guilt-trip them until they get you what you need. Play into their stereotypes and convenient narratives.
I know a lot of us are gentle and just want to exist. We don't want to play into these stereotypes. We want to try to abide and trust the system, because that's the easiest way. We see laws that protect us and think people will go by them. Unfortunately, laws won't protect you from casual bigotry or getting jerked around or misdiagnosed or told that "You have undiagnosed trauma we need to look at first".
Doctors are in a position of power. There's just no getting past that. They have authority over medical matters, and even if they don't make the final decisions for us, they can and will withhold care like this for any reason.
Lie. Lie. Lie. Lie. Lie. If it's not on paper and there's no witnesses or cameras they can't prove shit. Get supportive friends and family members on the same page just in case. Avoid getting major mental health diagnoses on paper until you approach the trans shit first. Don't give them any reason to doubt you.
Say you always felt like the gender you're transitioning to, even if you didn't. Especially if you didn't. Sell them a narrative of absolute agony. Dispense with anything more complicated or wishy-washy than "I am a woman/man and I need medical support to feel comfortable in my own skin." Play everything in your life the fuck up for sympathy points, while connecting it to your transness. Make shit up if they can't prove you did or not.
If you're a she/they and want feminizing hormone therapy, pretend to be hyperfeminine and she/her it up just for a little while. It'll hurt, but you need to pretend to be what they expect out of you. Opposite for the transmasc boys here too.
You got an awakening or realizing-you-were-trans story in early childhood? No? Make one up. They'll never know.
You got any bullies that made fun for you for being queer? No? Make a few incidents up. They won't check.
You just feel like you'd be happer if your body matched your gender identity? Yeah? That's awesome! I love you and support you. You should say that too! But don't only say that, because that's never good enough for them.
You got bottom dysphoria? No? Well now you do. Lie about it.
You got top dysphoria? No? Well now you do. Lie about it.
No dysphoria at all? No? Well now you do. Pick a few stereotypical ones and lie to hell and back about it.
You're nonbinary and would prefer to be on T or E to be more comfortable in your body? Great! Love the energy! I totally support that! But Doctors don't give a fuck about enbies, just pick whichever one suits the type of transition you need and fake it no matter how much it hurts (and I know it will hurt.)
Doctors aren't your friends. They're not out to help people. They're gate guards you have to say the right words to talk your way past. The sooner you get on board with that, the sooner you can start playing defense against them rather than letting them just deny and walk all over you.
I wish it wasn't like this. I really, really do. But it is. Proof of all these abuses isn't hard to find. Talk to basically any 3 trans people and you'll get 6 stories of medical professionals fucking them over somehow. And, gestures vaguely at everything they do to intersex people.
Doctors aren't your friends.