Congratulations! You're first visit should be pretty chill. They should talk to you about how long you've felt this way, if you've taken any steps to transition, a health history, and if they're good, they will ask about your support system.

They should go over all the potential risks and effects of feminizing hormone therapy, including what's 'permanent', how long changes take. You should also be open if you smoke/vape - it won't preclude you from taking E, but if you smoke you shouldn't take it orally.

You should have some labs drawn for baseline levels. Usually they check estrogen, testosterone, a complete metabolic panel, a complete blood count, and they should probably do prolactin and a lipid panel (lipid is a fasting panel ideally, but if you're not used to having your blood taken make sure you eat something before the visit).

You can usually start the medications before getting your labs back, unless you have a medical history that warrants waiting, although that's kind of up to the prescriber.

Visits should be every 3 months the first year, then 6 months the second year, and them yearly. You may need slightly more frequent visits if you change the route of your medication, or if you're labs aren't in the goal range.

It's important to look into minority stress and see if they have any resources or groups they can connect you with. Trans folks have higher rates of mental illness - that's not because there is something inherently wrong with us. It's because we live in a society that can be very hostile to us, even in places that are considered progressive. Start working on resilience now, and try not to do it alone. It's a lot.

Finally, my personal recommendation is to look into voice lessons, especially if you are not socially out. Not only is it rewarding to have your voice reflect who you really are, having the space to try out your identity, name, pronouns, presentation, etc. in a safe and affirming space can be just wonderful. It really helped me figure some things out when I wasn't sure exactly where my path would lead.

And, in the ancient wisdom of our people, just remember - you got this.

I don't know what the process will be like for you at all, but I went in as a complete and utter idiot and came out absolutely enlightened because everything was explained to me without me needing to prepare or prompt at all.

For a first appointment, just knowing what your goals are is likely enough, it took me an initial consult followed by a second appointment to talk about options before a third appointment where everything was set and all the necessary tests could begin. Fourth appointment I walked out with my prescription.

I honestly think you've got all the main questions covered, if your endo is providing referrals to things they might also be able to offer a referral to a voice coach like mine did (but mine was all through an informed consent GP so it might be different).

Best of luck, I really wish you didn't need that accursed diagnosis, I'm sorry you have to go through proving you exist.

Medical transition sounds very daunting for me, I'm avoiding that step. Why? genetic complications : my grandmother died in response to an estrogen-based menopause treatment, but she was negative for the one genotype that is known to cause this reaction. So I have a 25% chance of inheriting a genotype that is not known, but i know it has caused a relative to die of cancer, in response to estrogen. So I need to consult a doctor that specializes in hereditary (breast) cancer, but also consult with an endocrinologist who knows about estrogen-related cancers... that's a lot of work and if I skip it I have a 25% chance of dying within a few years of starting treatment.