Yeah, it would drive me nuts to be called "ma'am" for an hour -- of course, the way you wrote it is making me think that it was a bunch of people, or even just one person following you around and repeating "ma'am" for an hour straight. That would drive me nuts on various levels. Of course, one of them would be the fact that I'm under thirty years old and unmarried -- I am not at all old enough to be "ma'am", even if that was my proper honorific. Hell, I often get read as five years my junior, even when people do still occasionally mistake me for a lady, which makes it even more insulting -- like, they admit that they think I'm twenty-two or such, but still address me by the same honorific as was enforced by all the nuns of my old school, except Sister Zoe (my kindergarten teacher), who was twenty-one, twenty-eight when I moved, and was informally addressed as "Miss" the whole time. "Ma'am" is for married women and spinsters, not for teens and twenty-somethings lacking a band.
Yeah, can't really say much to somebody else's "required RLE" for HRT and so on. I admit, I am rather lucky in having easy access to a local TS/TG therapist who is often rated as "one of the top three in the U$" (Dr. Sandra L Sammons) -- she's a part of World Professional Association for Transgender Health (WPATH) and is rather permissive when considering the self-expression of her TS/TG clients. My primary care physician (Dr Pamela Rockwell, DO) isn't a TS/TG specialist, she is familiar with TS needs, the standards of care, very friendly, and about as permissive as Dr Sammons for expression. Both also realise that all patients are different and while any standards of care is a decent outline, it's not a one-size-fits-all thing, and sometimes adjustments will have to be made to best serve the patient.
You could always move to Ann Arbor or Ypsilanti, Michigan -- I may hate it here, but it's a great area to transition in, I'll give it that. ;-)
