This sounds like a great first step for him. I’m guessing it doesn’t feel great that support for you is conditional on you receiving mental health counseling. There are a few conditions that might look like gender dysphoria but are not (Dissociative Identity Disorder, in which a person has multiple parts living in the same brain, some of which may be a different gender, and Borderline Personality Disorder may lead some people to constantly switch identities), but generally speaking, and even with those disorders, it’s best practice to trust the person that says they are transgender and support them however they need.

Mental health counseling may still be a good idea for you. First, it’s good to establish a relationship with a mental health provider who can write letters of support for you to give to pcps and surgeons to help you receive any care you might need. Second, transgender people often have co-occurieg mental health issues. This is largely due to your identity being rejected during childhood, which causes gender minority stress. Some have theorized that DBT (dialectical behavioral therapy) might be a good fit for people with gender dysphoria. And mindfulness, anecdotally, has been very good for me personally dealing with dysphoria. It is not a replacement for transitioning, though. A self guided transition still has the most evidence supporting its efficacy. And mental health should not be a prerequisite to transition related healthcare, even though it unfortunately is sometimes.

I am a social work student, not a mental health professional, so take what I say with a big grain of salt.