A pro tip I've learned is to find whatever "informed consent" clinic is easiest to access, even if they don't give all that great of care. Even self pay online stuff like Plume. If you've been on hrt for 6 months or so, lots of docs will take over your HRT care without any gatekeeping since they assume if you've been on it that long, they don't have any liability or duty to run you through their gatekeep.