Imagine if a healthcare professional denied treatment after such a long wait. Which does happen btw, frequently. It would be better if the NHS just didn't provide GRS appointments so Trans people can plan and save up to get them abroad
You assume of course that NHS HCPs want to work in this field. Provision is constrained by the numbers of people willing to get involved in "affirming" this immersive fiction with drugs and surgery. There are many HC specialisms to chose from and people can't be compelled to do that job.
GPs don't want to be involved as it's too specialist for a GP.
There is more money to be made in the USA where the cost of cosmetic surgery is high and so practitioners will earn a lot selling any modifications to anyone that asks.
There's plenty of activists that practically give away hormones to anyone that asks to circumvent careful evaluation.
I read that China has banned the export of the raw materials for bathtub hormones so that's going to change the DIY/doctor shopping market again.
And yes, NHS hair removal is ridiculous.