Just a note on Premarin. Look, this is a hazy memory, so it might be false. But I think I remember reading that Premarin is one of the forms of estradiol that are the least potent and have the most side effect risks. You might want to look it up, and if I'm right, get information about another medication, like Estrace, for example.
And I have to second this: if your doctor thinks that good but not excellent cholesterol is an obstacle to HRT, there's probably a problem. You might want to try to convince them of the importance of HRT, or find someone else.
Me, I just solved my endo problem by calling a gynecology clinic. They prescribe hormones to menopaused women, after all. I called, asked about my case, and they said it was all right, that I could bring my referral. And it solved TWO problems actually, because the closest endo, which I was seeing, is 2.5 hours away, and the second closest who sees trans people is 5 hours away. The gynecology clinic is half an hour away and has, like, 10 doctors.