For me patches work really good. I apply them to my butt and put a tegaderm patch over it to make it more resistant to water and movement, I don’t ever have to worry about it coming off. Cost is also not really a problem since most of the cost is covered by insurance anyway. My last blood levels were 123 pg/ml for E and 39 ng/dl for T (these are my levels with my starting dose (75μg/24hours estradiol (with 2 patches per week) and 10mg cypro), since then I could decrease my cypro intake by a little bit). Regarding the anti androgen I don’t really have a choice since that is whats used here in Germany and also my endo only prescribes dermal application estradiol, so spray, gel or patches and she doesn’t do monotherapy as far as I know. But since I’m planning on doing bottom surgery in the near future anyway I don’t worry about that too much.

Edit: And injections are unfortunately almost impossible to get here.