Well at least you got a diagnosis. My doctor gave me a testicular exam (presumably to establish whether I'm XXY, which I'm not - it's definitely secondary hypogonadism), after which he announced that my testosterone was normal and there was nothing wrong with me, goodbye, see you next year (he wouldn't let me see the blood test results though). I've been self medicating ever since.
Following that I was seeing a gender therapist for a while who was going to get me into a gender clinic, but unfortunately by that point my money had run out (I've been out of work for 3 years now), and I had to let the place I was renting go and move from that area. So I don't know how a gender clinic would handle someone who doesn't identify fully as either male or female, but my guess is that they're entirely geared towards the gender binary.
If you look at what people say on hypogonadism and hypothyroid forums, it seems that they have a universally poor experience on the NHS. Medicine in the UK is extremely conservative and they're decades behind the rest of the world in a lot of the treatment they hand out. On top of that, the NHS spends nearly all of its budget on management, admin and pensions, so they're cash-strapped and always looking to cut costs when it comes to patient treatment. Any excuse they can find to avoid treating you, they'll take it, as you've already discovered it seems!
Here are the US guidelines for treatment of hypogonadism in males:
https://www.aace.com/files/hypo-gonadism.pdfYou'll note how one of the things doctors should be doing is checking your bone density every 3 years, since if you have any form of congenital hypogonadism, you're at high risk of developing osteoporosis as you get older (especially if you're not on HRT).
Here's the EU guidelines:
http://www.uroweb.org/gls/pdf/17_Male_Hypogonadism_LR.pdfI have secondary hypogonadism, whereas, if you're XXY, you'll have primary hypogonadism. The overall effects of the two are fairly similar, the main difference is that someone with secondary hypogonadism can take fertility meds as an alternative to TRT (which is what I'm currently doing).
FWIW, here's the only UK guidelines I've been able to find:
http://www.endocrinology.org/policy/docs/10-12-01_UK%20Guidelines%20Androgens%20Male.pdfThere's essentially no content of value in those UK guidelines, but if you look through the US and EU ones I've linked to, you'll see that it is quite important not to have both your testosterone and estradiol low for extended periods of time. Not only does it completely destroy your quality of life, it can irreversibly damage your health too.
Did you know that, in both the US and UK, you can buy womens HRT hormone creams online? They're not strong enough to drive a full MTF transition, but they can give you some of the psychological effects of female hormones. One option might be to see whether you can get TRT through the NHS, and then supplement with women's HRT cream. My experience has been that progesterone and estriol make a very nice combination once you get the dosage right!
