Yes there is a lot of gatekeeping happening across the board. From my wife's experience living just outside of Portland Oregon:

- Prescription has been cancelled twice for no real reason.

- Pharmacists have refused to give more than one month at a time more than once.

- Even if everyone is on board and not hostile she's only able to get a few months at a time so she has to do this multiple times a year.

I can't imagine how it'd be if we lived in a more conservative state or in a more rural area.