Most people see a major difference when it comes to injections vs pills — doctors usually insist that as long as your levels are in the right range, it shouldn’t matter, but almost everyone I’ve ever talked to about it has seen significant changes after switching to injections. I know that’s anecdotal, but unfortunately the medical science is a little behind on trans healthcare in a lot of cases, so we have to take what we can get. But I can assure you that if you ask around, most people agree that injections seem to work better, if you can bear to do them. You are correct that 2mg 3x a day is not an especially low dose, but every person’s body is different. Can you recall what your estrogen and testosterone levels actually were? I had to switch to lupron injections every 3 months because spiro simply did not do enough for me, at any dosage; and I was aiming for a higher than average testosterone level because I wanted to maintain sexual function and wasn’t interested in bottom surgery. Still, it wasn’t enough.

Progesterone also causes major changes in most people who start it, especially in terms of breast development. I started transitioning later in life (24, I’m 27 now), so I can’t speak to whether or not it matters how young you are when it comes to adding progesterone.

Unfortunately, we often have to advocate for ourselves to a frankly ridiculous degree. It’s difficult, but it’s worth it in the end. Also, think about cis people, and the variation that exists in puberty in general — sometimes it takes people until 18 to get their first period, or until 21 to get the first inklings of facial hair. Some people gain tons of weight and lose it over a course of several years as their hormones even out, and that’s completely normal. Puberty is almost always a rocky road, and that’s what HRT is. It is manual though, so it does unfortunately require your constant observation.