A GP may reasonably decline to accept responsibility for prescribing, monitoring, and testing if they aren’t sure that the recommendation for prescribing has been made by an expert gender specialist.
They can also only do so as long as they believe that declining responsibility wouldn’t pose a significant clinical risk to the individual. This is a question that often comes up in biomedical ethics.
Here’s what the World Professional Association for Transgender Health (WPATH) says on the matter, as it pertains to gender dysphoria in adolescents:
“Refusing timely medical interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatisation. As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al., 2010), withholding puberty suppression and subsequent feminizing or masculinising hormone therapy is not a neutral option for adolescents.”
Similar arguments can extend to transgender adults who are suffering with gender dysphoria and denied potentially life-saving treatment.