Please bear in mind that I'm writing about the UK. Your experience may vary!
I wrote to my GP on Monday, confirming my wish to be referred for a Gender Identity Clinic, adding that I would also like an Orchidectomy. As an elective procedure (and not being performed at the same time as GRS) there's likely to be a fairly long wait for an NHS date.
Nothing back from my GP yet (no surprise there) but I have been checking if my private scheme includes Orchi - yes it does. I rejoined the health scheme earlier in the year and there's a 6 month restriction before you can have any treatment, that expires next Sunday!! One condition is that I must have a GP referral so not 100% will get that soon (but if you don't ask then you definitely won't get!)
One bonus - I received a £20 M&S gift card when I rejoined. Finally yesterday drove to an M&S Outlet Store (Marks & Spencer branded remainders & discontinued lines). I picked up 2 cotton tie up short skirts at £10 each and a long stripey top for £5. All size 16. So cost me a fiver! Oh, two of those items were the last size 16 on the rails!
Update: List price for the skirts was £17.50 each, top was £14. So £49 worth of clothes for a fiver!