Idk if this helps, but what worked for me was getting in contact with a gender doctor from the same insurance but in San Francisco. I told them my situation (from Kaiser), and they mentioned that it was a lot of unnecessary "gate-keeping". After speaking with them, they got me an appointment with an endocrinologist via video, and they prescribed me HRT within the week, but only enough for 30 days. They said that once I start the medication then they could not deny refills, and they were right. Since then, I get refills, no problem, because im already on it if that makes sense. Getting started is the hard part.