HI Dark goth,
I think everybody is different so it varies what works the best for you. I think most people start out with pills.
I've been taking T-Blockers and E for about 5 months now in pill form. The T-Blocker pills are yuck but E pills taste kinda good. Changes are pretty subtle over time but I have had some small amount of breast development, loss of muscle, and a small amount of fat redistribution to my butt.
I haven't tried anything else so I can't really say, but I've heard good things about injections.
I think most people can adapt to speaking with a higher pitch and more feminine tone. The best place to start is with a speech therapist for voice, as that will probably be far less difficult than voice surgery. I don't think hormones make a difference if your voice is already low, but I think a lot of your vocal cords is how you speak from day to day will effect it, so if you start going up in pitch slowly, it will be easier to raise your pitch than if you try to force it.