Now this actually is a heartwarming story, setting aside the need to do all these things in the first place. Congrats on your gender-affirming care!
My wife at one time worked as a sort of–well you’d call her a malicious compliance specialist. Her fulltime RN job at the care center where she worked was to write plans of care. Basically the doctors would tell her what they intended to do, and she’d write up documentation phrased in the precise way that would get an insurer to approve it. That was her job. Just the phrasing. Occasionally she’d have to go back to a doctor and say “Hey, they won’t approve this unless X condition is also true, can you please write down that X condition is also true,” and then they did that. (This wasn’t frequently necessary, because the doctors were also very well-versed in working around the insurance system.)