What most (US) providers do:
-stick you on a low to medium dose of oral/sublingual estradiol and spironolactone, usually one after the other (better to start with e though).
-check liver function
-iterate dose based on tested hormone levels and how you subjectively feel
-if you can't get where you want on sublingual estradiol, switch you to patches or injections
-give progesterone if you specifically ask for it.
@starkatt my initial doctor didn't do sublingual, interestingly, and wouldn't give me progesterone