Transfem

honestly same, I have needle phobia, e.g. I nearly pass out when getting blood drawn and I wasn't sure I would ever be able to actually mentally put a needle into my body.

But I learned ways to make it work - I inject subcutaneously instead of IM, so I use tiny needles that usually cause no pain at all. I learned a ton of different tricks to make injecting mentally doable for me and to reduce chances of passing out, and safe in case I do pass out. (Let me know if you want me to share those with you, I have a whole write-up about it.)

I won't lie - it was difficult for me at first. But it also got much easier than I ever thought it would, and now it's pretty much trivial.

I still decided injecting was worth it compared to other methods, and I stand by that in my results. I have had better feminization than trans women I know IRL who started HRT around the same time who just use pills.

My endo agrees that pills are a terrible way to take estrogen, she points out that they cause massive spikes and dips throughout the day rather than maintaining a steady blood level. Also, like 80% of the estrogen is eliminated by the liver and doesn't get into the blood-stream, so it's just inefficient and an unnecessary tax on your liver (though I don't think bioidentical oral estrogen is particularly risky, either).

EDIT: if not pills or injections, transdermal is an option, but I consider it a better option post surgery, since I found I needed higher doses when I still had testes. In the U.S. you generally have to be on HRT for a year before they'll do an orchiectomy (I wanted one immediately, but was gatekept for a year, and I got an orchi ASAP - literally within weeks of my 1 year HRT anniversary, highly recommend it - was great).

Bicalutamide didn't work for me as an anti-androgen, I suspect because it has weak impact on the central nervous system and wasn't blocking biochemical dysphoria in my brain, which was the main reason I personally was on HRT.

I never tried spiro but didn't even want to try, it's a very weak anti-androgen and has side effects and some risks, I just never thought it was a good idea when monotherapy was an option, which is easier with injections and not as feasible or reliable with transdermal routes (patches, gel).