Way back in the days when the Charing Cross Hospital gender unit was the only such unit outside (probably) of the USA, the psychiatrist was Dr JB Randell. No-one could come to the surgeon except through him.
And he had a trick that he tried at least once on every m-f transsexual. He tried to goad them, provoke them, to anger, to see what they would do. If they responded violently or stormed out, their case was doomed. If they burst into tears, that was OK.
It may seem primitive but that's how it was.
It made me wonder whether Ms Hudson has not progressed with her surgery because every psych finds her to be a violent nutter.....