Well, when I was in PA, I went to a clinic with a sliding scale based on income. I think I paid $20 to get my letter.
I later got on Medicaid and that covered all Doctor visits and most of my drugs. I had to pay for half of my estrogen because the insurance wouldn't approve the dosage. The doctor told me about an app for your phone called good rx if gives you coupon codes and the prices with the coupon. That helped a lot.
Now I've had to move to New Mexico. When I got here, all my prescriptions were running out, so I made my first stop the transgender center of New Mexico. The wrote me prescriptions and did it for free as I'm technically homeless.
I was able to get my spiro at no cost at their healthcare for the homeless clinic. I still get my patches at Walmart using the coupons, so that's a little tough, but still only around $25 for 4 patches. It only lasts two weeks though.
For what it's worth, Albuquerque isn't too bad and once I get back on Medicaid, things should be a lot easier.
Keep looking online and consider all your options.
Oh yeah, I was able to have the doctor at the healthcare for the homeless fill out the form for the gender change on my drivers license.