Hey Jamherst (looks like it was intended as J. Amherst, but I'm going to nickname you Jam anyways in a rather patronizing manner)
Jam, I'm in pretty much the same boat as you; I see myself as a boy, but not manly at all. To have more T in my body than E would fit better with my gender identity, but I'm not sure if I would end up at all happy looking like a man. I've had low dose T suggested to me too, but from my understanding it doesn't result in less of a male puberty, just a slower one.
The main things that are important to me as I see them now are similar to yours: losing the breasts and the menstrual cycle, and if I could I'd like the reproductive organs and estrogen to go as well. Among things that are not that important to me: developing male signifiers, acting or feeling masculine, passing as a man. I just want to be happy with myself.
I guess I'll go ahead and share some of the options I'm considering now, although I don't have a good answer to your actual question.
My first priority is getting the bleeding to stop, and I haven't been able to tolerate the easy solution (birth control pills). I'm still looking at a few other forms of birth control that would stop the cycle. Depo-provera was my first thought, but the internets tell me it only stops bleeding completely about 50% of the time. My therapist recommended a hormonal/IUD "Mirena," which is highly effective, but at the moment I'm disturbed by the thought of some device being in my uterus. I'm a little uncomfortable with the progesterone based meds to begin with, but I'd feel better about it if I found an understanding gynecologist.
I'm also looking at treatments for endometriosis which totally shut down sex hormone production. They're also the same drugs used to delay puberty in young TGs. Unfortunately, they're still a temporary solution after puberty. With low sex hormones you'll lose bone density quickly, and have to worry about tripping on a shoelace and breaking your hip like you're 80 years old. So these meds are given in short courses, which is enough to stave off endo but will not make a permanent transition.
To deal with the chesticles, I've pretty much set my sights on bog standard FtM top surgery. I've heard of plenty of doctors willing to do it pre-T, which would serve equally well for a totally non-T transition or starting it later in life. I previously considered just a reduction - removing the fat, leaving the breast tissue - but I'm not so unhappy with the size as just their existence at all.
I'm hoping that a hysto is in my eventual future, but it's extremely hard to get approved for a young "woman" who has never had children. There's a huge bias in the medical community (well, in most of humanity really) against anyone who is young and wants to be permanently sterilized. I will have to get my therapist to argue on my behalf when it becomes an option for me.
I'm not particularly knowledgeable about physical treatment, but I'm happy to discuss it with you anyways. Or we can, you know, talk about our feelings. o_O I know that the binary has really gotten into my head as well, but I'm trying to cure that by hanging out in the Androgyne forum.
