Transition - the process of changing one's social role from one sex to the other - is something that the medical profession only helps with conditionally. Contrary to popular belief, it's not something just anyone is allowed to do.
Note the word "allowed".
Someone can get plastic surgery to enlarge or reduce breast size just by paying for it. Someone can get a hysterectomy on demand, or even have testes removed. But to get legal access to hormones, and later, surgery, that's a different matter. The medical profession insists on having a "gatekeeper" role (for the patient's own good of course), treating them as being incompetent to make their own decisions.
The situation is self-contradictory; on one hand, any psychiatric illness that would affect the patient's competence to make their own decisions is an immediate disqualifier. That's the first thing that's checked. So they have to be competent, or they can't proceed. But then they're treated as if they're not.
When the "gatekeeper" is reasonable, rational, and competent themselves, this is no big deal. But not all are. Some insist on unreasonable conditions, and unless the patient acts in accordance with their stereotyped beliefs, they will withhold treatment, refuse it.
This has led many feminists to label trans women as fakes, as men who denigrate women by acting some Doris-Day stereotypical role, presumably for some kind of sexual thrill. They don't know, or don't care, that this act is just one more humiliating indignity forced upon trans women in order to be authorised necessary medical treatment.
This was almost universal in the past. But it still happens. Here's an article detailing one patient's experience, not in the 50s, but in 2009.
In early 2009 I was finally given my assessment for suitability to go on the waiting list for sex reassignment surgery. Yes, that’s right, I would be assessed as to whether or not I was suitable to wait in line for further assessment.I had very little of this. Mostly because I was in the hands of a competent medical team, but also because I didn't quite fit the usual Transsexual situation. Had I been confronted with these kinds of demands, I would have sought another psych, because I'd have no confidence in the professional competence of anyone who behaved like that. And if there'd been none available, I would have proceeded anyway, via less formal means if available, otherwise by playing the sub in their little sublimated BDSM game if need be. "Single minded" doesn't really cover it, "implacably determined" does.
I wear black. I like wearing black. I was told that women do not wear black....The woman doing the assessment was wearing black. Nothing but black. She told me that women wear bright colours. Pink was the only colour she could name.
The psychologist actually assumed I had short hair – either she was blind, or stupid – and said that women have long hair. On having it pointed out to her that I have long hair, and was wearing it tied back due to the wind, she said that women never wear their hair like that. She certainly didn’t, since her hair was about an inch long...
I was wearing a skirt. It’s hard to miss this on anyone, more so when someone is sitting cross-legged. She assumed I was wearing trousers. In her strange view of the world, women never wear trousers: they only wear skirts – and not long skirts, not even when it’s cold out. They wear short skirts. Knee length is still a long skirt. Mid-thigh is apparently the universal dress code for women. Unless they wear dresses, of course. No woman ever wears trousers. I’m sure the astute reader will see where this is going… Yes, she was wearing trousers.
The ever more ridiculous and outdated stereotypes continued: Women all wear make-up. But not subtle make-up. They trowel it on, so that it is clearly visible. It must be noticeable, or they’re not wearing make-up. No, she wasn’t wearing make-up either. I personally don’t. I’m very poor and could not afford any make-up if I wanted to wear it. Since I was raised by parents who were both feminist enough to think that make-up is something that women are not required or expected to do, I certainly don’t feel any pressure to bother. But the notion that maybe it’s sexist to require women to wear make-up was flatly disavowed by the psychologist. She said that all women wear the stuff, all the time. Except her, of course.
Then there was my lack of high heels. You see, all women wear high heels (except for certain psychologists)....I was told I should wear high heels. Even though I often cannot find any that actually fit.
On hearing that I’m attracted exclusively to women (there was a flat demand to know my sexual orientation) she said that only men are attracted to women. I asked her if she had not heard the term lesbian. She repeated what she said, so I think the answer was “no”. I guess lesbians are just too cutting edge.
It was pointed out to me by the psychs that there were options now I hadn't considered before. That I could wear makeup if I wanted to. Or heels, or frills, or whatever. But... that's not really me, and never was. Maybe it should be, a bit. Having 47 years of hiding, of being deathly afraid that someone would find out my Dark Secret, that's left me with some psychological hangups in this area. But nothing major, and nothing I can't fix myself, in time. I enjoy wearing ear-rings, having long nails, and have discovered the joys of a little Chanel No 5. If my body looked more attractive, maybe I'd do more... but it doesn't. The point is, that's not exactly a dominating concern in my life, I'm more involved in writing up my PhD thesis and preparing the courses I'll be teaching next year. Bringing up my son is more important still.
I wasn't called on to play the performing seal, to jump through hoops on command. If I had to, if there was no other alternative, I would have. You can only be humiliated by someone if you give them permission though, and I would have withheld that.