I have found that while my Doctor is very experienced with trans patients, he values my opinion too and assumes I am well informed (as many trans patients are). I remind him when labs are due, prescriptions need renewing etc. I ask for letters when I need them. He is openly interested in my wellbeing and that is always his first question - "how are you?" I am always open and honest. For the doctor-patient relationship to work (and it is your health we are talking about), it must be about great 2-way communication. I have been to similarly qualified doctors who just rubbed me up the wrong way and I moved on until I found one I wanted on my support team (primary care doctor, Psychologist, Psychiatrist, speech therapist and wife!). He hasn't given me a single moment to doubt that he is a good one. I do see him every 2 weeks for allergy shots so we are getting to know each other pretty well!
With regard to HRT, I asked for the average dose to get done what I need done. There has been no need to change E (hit the target level inside 3 months) but I was moved off spiro recently as my blood pressure started to get too low. It did the right thing for my T levels but caused other issues. My Doctor did say it was nice to not have to fiddle with dosages as it made the process much harder. However, everyone is different and you really need to be willing to observe, communicate and listen
Emma.