In both instances, medicalization of these things is such a huge cover-up for bigotry.

People who accuse trans people of having a "mental condition that needs to be treated either without transition or with excessive gatekeeping" aren't looking out for their best interest. They just want to attempt to logically justify their transphobia, which, in actuality, stems from a "trans people are icky" mindset. They know well enough that calling something "icky", however, doesn't serve as an actual argument, though, so they have to pull some kind of rationale out of their ass, even if it's rooted in falsehood.

Fatphobic people are the same. Once again, they're not concerned with them being "unhealthy". They just think fat people look unpleasant and want to try to rationally justify it by seeming empathetic about their health when they're obviously not.

Thank the gods for informed consent clinics. I'd probably still be fighting for HRT to this day if I had to go through the standard avenues without informed consent.

That being said, I do wish I could do something for comrades that don't have access to informed consent clinics. I just don't think there's a damned thing I can do.

Let's not even begin with the trouble fat trans people can run into at their endocrinologist. I've met trans women who were gatekept for over a year (in addition to the general gatekeeping of HRT here) due to their weight and age, even though estradiole gel has practically zero increase in risk for blood clots.

What's the problem with the diabetes drug? Is it just because the fat person didn't ask? Also damn, I feel awful for people who have these kinds of doctors, I feel lucky cause I've never had to deal with a doctor like that.

I'm assuming gastric bypass? Knew someone who did it. They got unhealthily skinny Imo but that's a them call plus I'm hella biased and like cuddling big dudes. It's hard to do but I think it would've been better for them to do it naturally first, instead of gaining the weight to then necessitate the surgery. Again just my opinion.

I can't speak for doctors everywhere but in my experience doctors are not trying to push bariatric surgery on people who doesn't need it. If anything they're gatekeeping that as well since some people mistakenly believe it to be an easy way of doing weight loss. The doctors I speak of are all operating inside a public healthcare system though and I'm sure things are different at private clinics where people pay money up front themselves.

Someone near and dear to me recently had bariatric surgery after a years-long process of tests and assessments. Although it has a lot of nasty side effects their quality of life has improved immensely. They're able to move around freely in ways they couldn't before, their body doesn't hurt all the time, they are mostly rid of their painful oedemas, their self-image has improved incredibly and their chance of living to know their potential grandchildren has increased significantly.