That was a pretty brutal assessment. I won't vote for finding another therapist *only* b/c you say you're otherwise happy with her, but wow was that harsh.
I started HRT with about 18" shoulders, 16" wrists, big-looking hands, and size 11 [women's] feet. I've since gone down to 14" shoulders, lost a shoe size and a half, measure an inch shorter in height, have 13" wrists and much smaller-looking hands. Never underestimate what losing muscle mass will do, and I didn't even know it was possible to HAVE wrist and hand muscles to that degree! Not to mention that it's all about proportion; since I now also got bigger in the boobs, hips, butt, and belly, there are new feminine features to distract from the rest. You stand a good chance of ending up, as others have said, looking like a very pretty tall woman.
(My wife also has 22" shoulders, and has never even had it commented on.)