Learned some more today.

Apparently, my first therapist did manage to get some letters written in a timely fashion through the summer, allowing people to meet the requirements to get dates with the same surgeon in the later part of this year. This was during the time that she was unresponsive for me, taking months to write mine.

This makes for a clear pattern of behavior. She intentionally made longer requirements for me for both access to HRT and surgery. When, due to life circumstances, the longer requirement for a surgery letter didn't impact me she went out of her way to cause a delay (and, for the record, it did cause a delay of my surgery date, but not a significant one.)