Here's gatekeeping.

I've found that the concept I've had the most difficult time explaining to others, particularly cis people, is the one that has lead most of the battles I've had for transition, and its name is gatekeeping. This was the reason I loaned my parents my copy of "Whipping Girl" in an attempt to get them to understand.

I had it last year with my therapist and my now-former endocrinologist. I was having serious issues with my endo that resulted in her refusing to give me proper treatment. I did my homework and found another in the area who was good - well regarded, experienced, etc. I needed a referral to get scheduled with her so I went to my therapist and told her all of this. She refused, giving reasons that I knew to be false.

Sunday evening I came into some information which, when combined with this experience, made me realize that she might attempt to similarly railroad my choice of surgeon for SRS. She has strong opinions about surgeons, and I'm not just talking against the hack ones, and it's not at all difficult for me to see her refusing to write a surgery letter for me if I want to go to a surgeon whom she does not approve.

I was able to work around the endocrinologist issue by using my GP to refer me since there was no requirement about who made the referral. But a surgery letter is a different matter. I'm changing therapists now for this reason: so that I do not find myself possibly having to cancel a scheduled surgery because she has refused.