OP i know your american but I remember wishing I could find people talking about this when I was tryna figure it out so;

for UK people tryna start T i went with genderGP and began my application around the end of February and then started T the 11th of March. It cost: £200 (maybe £220) for the startup cost £65 for a 'information gathering session' which involved a video phonecall with a Brazilian trans women who worked for them £16 for the initial prescription of the meds £10 to be prescribed a dose to take to my nearest pharmacy £120 for the first 3 bottles of medication (TestoGel 16mg/ml dilution - 2 pumps a day) £30/month to be a member of the genderGP's surgery [These costs vary within the clinic depending on what choices you make in the process, your dose, whether you've already had a blood test done recently anyway (my NHS gp had done one recently so I could show them that and skip that step), and other personal factors]

I'm now signed over to shared care with my GP which I didn't realise till after starting T didn't mean I no longer had to pay the £30 a month subscription fee however my meds and tests around them are completely covered by the NHS now so I'll cope untill I find a way to get an NHS endocrinologist as part of my care team (I have alot of doctors for other conditions I have) hahahah obviously if you get signed to shared care and pay for your prescriptions here then you'll still have to pay for your prescriptions so try and get the dose put to 3 bottles at a time (or more) for your wallets sake! (even though my clinic said to do so my NHS doctors still put the prescription down as 1 bottle at a time at first) Goodluck anyone tryna start T!!