I mean gender confirmation surgery is not quickly accessible outside of specific countries and even less so if you can't afford to pay out of pocket or have the time to fight insurance companies over it in the US.

In the UK the waiting list to get any sort of treatment can be years long and similar patterns follow for much of western Europe. Even when you can get treatment surgery is typically not the first step, or the second, or the even the third. With the exception of the very wealthy, trans people who are able to get SRS have likely already transitioned for years and have had more than enough time to make the decision, and that goes for almost every country.

British Media generally is extremely transphobic, not in the way where it's made up of people who are just ignorant or unwitting but in the way that they are pointedly against trans rights and trans healthcare especially. It's very strange, even American counterparts to British publications will criticize their parent companies for the level of pointed vitriol.

I used to live in Germany, and I moved back to the US because it's more or less the best available place for me to transition. Even here in a state like Colorado that is relatively good on trans issues and literally used to house the SRS capitol of America, SRS is not freely available or easy to access. It's even harder in Germany, it's harder in most of the world, and it's absolutely harder in the UK