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I am really tired of this argument that trans health care is "just cosmetic".
When I walk out of my house every day how I read as male, female or something in between will color my every interaction with every stranger I meet. It also impacts how safe and confident we feel existing in public space. If people can "clock" someone is trans your entire experience changes. If you do not visually conform to the gender stated on your legal documents your world gets smaller. You cannot travel without potentially getting detained, searched or interrogated and some places you can't travel at all. You might be passed over as a perspective renter, refused service somewhere you need due to someone's "moral objections". Never mind how everyone will misgender you.
When you don't pass the world is a different place. People stare at you more, scrutinize you more, treat you with kid gloves or like you are mentally ill. They find it more acceptable to ask you questions about shit that really isn't their business. People who think people like you shouldn't exist can spot you at a distance and are more likely to stalk you to less populated secondary locations. People are more likely to harass you in general and the experience of just being legitimately considered "ugly" can ruin your self esteem because the overwhelming reaction you get from people is that they wish they didn't have to experience you. Then when you get home and look yourself in the mirror all of that compounds to the vision of yourself as a being who does not deserve kindness. That yes, you are ugly, incomplete and you never will be real enough but there's no going back because this is still better than where you came from. That this might be the best it will ever getand you just have to live with it.
To render that down to "it's all just cosmetic" is to ignore the entire politics of sex, gender and how transphobia shapes one's experiences. You may not think gender colors your experience but that is because you can take it for granted. That's part of the cis experience. That is an advantage that trans people do not have. We do not have the advantage or capability of not caring. We can try to ignore our needs but they are still needs. Ignored those unmet needs just become depression, anxiety, a pervasive sense that nobody knows you (just a fake version of you that is performed for their acceptance) , a deep loneliness and sense of being invisible.
It's is a good recipe for making dying a lot more attractive then having to keep up the facade of living.