Perhaps this feeling is a consequence, at least to some extent, of the near-ubiquitous before-and-after pictures of hormonal transition. These photos omit the difficult middle, offering instead an arbitrarily selected “after”.
Giving evidence to the Women and Equalities Committee on 8 September 2015, Dr John Dean authoritatively summarised the genesis of gender identity clinics [GICs]:
“there is quite considerable diversity of opinion between different clinicians and different clinics. All seven gender clinics in England arose out of the special interest of an individual a long time in the past. There has not been a lot of planning of their development, and there certainly is no training pathway for medical practitioners or others who work in this field.” 
Who were these individuals ‘a long time in the past’, how did they come to define the lives of trans people, and why are GICs such a focus of criticism from the patients they exist to serve?