Leakey's Report best trans-specialist is named Sylvania, she sticks to the hormones and self-identity part, but she's actually friends with many of the surgeons who've done 1000+ operations.
Clothes are acquired at "tailors". They're call them tailors even if they sell off-the-rack clothes, they're basically sole proprietors of clothing stores who have a real passion and interest in them, and that can extent do things like lingerie, diving equipment, snowsuits, PPE and other things that can be considered clothing.
The transition process is hormones/electrolysis/clothing first, with doctors mostly assisting with the hormones step, because there's a huge selection of different protocols to choose from. Any kinds of operation tends to happen following a relatively long period of social transition, and a relatively high % of transpeople don't do bottom surgery because they sort of like being "a gender of their own" and don't really feel the kind of dysphoria that warrants surgery. There is 0 gatekeeping for either hormones or surgery, but very, very few people handle their own hormone protocols or feel comfortable tracking their bloodwork without a doctor in the loop.