"Most clinic providers do not have an endocrinologist or psychiatrist on staff" - that's exactly the problem, the bulk of hormone scripts are being written by people who don't have relevant expertise.
It's one thing to get an interim script from a GP because the specialists are all backlogged or the patient lost his/her meds but that isn't what's going on here, Big Gay Al is mad because Ohio is cracking down on glorified prescription mills. It's also hard not to notice that gender medicine is the only field with this problem, most specialists will give you a weird look and a referral if you ask them for something well outside their specialty.
Edit to add: And if anyone can claim to be an ethicist, how is that an obstacle to getting treatment? Even if the ethicist can't be the same person as the psychiatrist or endocrinologist a gender clinic could just designate a nurse who already works there as an ethicist and have him/her sit through a few ethics lectures to head off questions from the medical board.
