I'm transitioning through the Reno VA and they have been very helpful and supportive. Dealing with trans issues is still relatively new to them and they're trying to get a more comprehensive system in place right now, but they've covered hormones (completely free! yay disability rating!!) and therapy pretty well for me. They even have a trans group that i'm a part of that meets there. They are also currently helping me with all the name/gender change stuff both in the VA system and everywhere else, and they always call me by my preferred name and gender even though it's not legally changed yet. I also think there is a good chance that I can justify orchi through them due to my higher risk of clotting.