You see, Italian, that letter gets me too.
It is an 'indignity' to face a 'medical diagnosis' to affirm gender.
That seems to argue that gender is an option that you can choose. As opposed to how it is presently understood as a by product of sex.
The current act requires medical assessment because self evidently if sex is one thing and gender is another then something appears to be wrong somewhere.
As such it is appropriate to try to find out what as the options include ones that are benign or harmful to the individual or harmful to wider society.
For instance, brain tumour causing delusions, or the result of a repressed trauma or a side effect of a fetish.
All things that reasonably should be eliminated before okaying access to any women's spaces offered by the act.
If you have true gender dysphoria that makes it impossible to live with a mind telling you one thing and a body another you surely have to want to identify the cause and the best resolution.
Which implies if you do not think this that your state is not something that is impossible to live with. Or that you can accommodate within your life in ways that you have been doing already without any desire to find out why via a doctor.
Or that you think is just a lifestyle expression.
Any one of these things seems to be different from a medically diagnosed problem for which full transition is the recommended treatment.
I just do not see how you can conflate these two different perceptions of a gender dilemma because they stem from different sources, have different depths of expression, might in the non assessed cases pose risks to the individual or society and will lead to very significant degrees of transition that self evidently has to impact on the way that the rest of society will have to interact and adjust in order to accommodate reversing gender.
I think the refusal to seek medical assessment is the acid test here.
If all that is standing between these 600,000 people and getting a Gender Recognition Certificate now is the 'indignity' of seeing a doctor to get the nod - then how come they are not prepared to go through what most will see as a minor inconvenience of an indignity to get what they seek.
When they are happy to as a consequence expect lots of others in society face other indignities such as be in their presence in a same sex environment.
This strikes me as a very selfish demand. One seeking to put all the burden of responsibility or consequence onto others because seeing a doctor is an indignity.