I think that sentiments like this are really dependent on the context that the diagnosis is made within. E.g. in countries with free healthcare, gatekeeping on some level is a necessary evil, not just in trans healthcare, but in general, to allocate funding. For example, I can't get braces for free despite my crooked teeth, because they're not fucked up enough to warrant it, so I'd have to pay out of pocket. I don't think it's that crazy that someone's HRT wouldn't be covered by the state if they're likely to want to change to the opposite hormone profile just 3 months later.
Or am I just completely misunderstanding what this meme is talking about? Obviously, in a private healthcare setting, the only requirement is informed consent.