Carys, honey, I am si sorry. Big hugs, baby. I know how bad and angry you must feel right now. Your psychiatrist is old school. For a long time, the medical and psychiatric world viewed the only path for tg people as binary...either full transition to female or not. So there were well meaning though incorrect safeguards put in place to prevent people who really were not right for srs from making irreversible mistakes. Although the world has changed greatly this last decade, and now recognises a vast middle ground, many old school doctors have not kept pace. I am not surprised a VA doc is among them.
What can you do?
You can self medicate or you can get more sympathetic help elsewhere.
If you choose the former it means either staying with herbs or obtaining hormones from overseas suppliers. That can be done. Ask sweet Sarah, as she has experience and can recommend good websites. It is quite legal, though a little more costly than through a scrip.
The other choice is to find a different therapist to see and get a scrip from. I dont know where you live, sweetheart, but most cities have TG resource sites that can point you toward tg friendly therapists, counselors and endos.
But do not lose hope honey. You will get there.
Feel free to pm me if you want even if you just need to vent. Sammie has your back, baby. I listen real good.
Hugs