Again, you are deluding yourself if you think capitalist lawmakers are any worse than come authoritarian lawmakers. At least capitalist ones can be nudged by activist pressure and existing demand into the right direction. Authoritarian lawmakers are the same but unaffected by any pressure or demand. It can be seen perfectly from the map of availability of ADHD meds, or opiate painkillers -- in authoritarian and backward countries, due to the lack of any influence on people in power, such crucial medicines just aren't available, yet they are available in the west, despite known actual dangers of their use for drug abuse purposes, that lead to many deaths in US alone. And if you want a weak state which just doesn't care about what's going on with the drugs, such state is also guaranteed to be a shithole in other aspects, in terms of safety, in terms of economy etc. One of your viable options is a modern western state modified by some form of pharmacological libertarianism, i.e. people are responsible for their own bodies and can buy whatever. Such libertarianism only possible when some more general overarching libertarian ideology is dominant. But such ideology also assumes expensive medical services, because since when you can do whatever with your body, nobody should be responsible for the consequences but yourself alone. That's a general solution, that solves other related issues, not only trans issue. But that's too far fetched and unrealistic, while still being more realistic than fantasies of tran-communism, or a separate country for trans. In reality the most viable political approach is to just continue activism in the west, annoy lawmakers by making them look bad and heartless, to eventually win a an good ad hoc solution for trans.