I am in the UK and under the care of a GIC. I receive Decapatyl injections every three months as these are considered superior to Androcur and Spiro. The reasoning is that rather allow T to be produced and then blocked, it is better to not produce it at all. It also allows the person transitioning to experience post-op levels of T immediately and a lower dose of E to be proscribed.
The risk of depression is less than that associated with Androcur and it lack the water-rentention problems of spiro (not to mention hyperkalemia).
My T levels dropped to female levels in a matter of weeks and immediate changes became noticeable, the primary one being tiredness. Within a few weeks body hair, when epilated, did not grow back as DHT was also reduced.
For those of you in the USA the big drawback of these drugs is the price, but they are routinely prescribed in the UK. The big advantage for someone like me, awaiting GRS, is that I can stay on this up to the operation as it is a depot injection.