Transfem

You will have to tell your family physician eventually once you start to medically transition, or if that's really not an option, you will have to find a new primary care physician (PCP) who you are willing to work with.

If you want to see an endocrinologist, it starts by getting a referral to the endo by either your PCP, or sometimes by a psychiatrist.

I live in the southeastern U.S. and here we have the Trans in the South Guide. I was in a similar position as you when my egg broke: older, supportive spouse, but not much else - I tend to be a hermit and cloister myself.

I used the Trans in the South Guide to find an endocrinologist in my area, and I called my PCP and told them I have gender dysphoria and I would like to be referred to the particular endo that was in the directory. By sheer luck my PCP was trans-affirming, and by coincidence already has some other trans patients (though I am his first trans woman patient).

The city I live in has a local LGBT+ Pride group, and there is a trans support group that meets - I started to go to support group meetings and just talked to people.

Connecting with your local community is usually the best way to find out which providers are good, which are bad, which insurance companies are good and which are bad, etc.

So first of all, find your local pride group, start going to regular in-person meetups and get to know people. You can ask questions there, but you will also get to hear people's stories as they have tried to navigate what you're about to go through. Even if there is no trans-specific group, just going to LGBT+ events will hopefully increase the odds of meeting other trans people that you can network with. Forming a group chat (or getting invited to one) was really helpful for collecting and sharing resources.

Finding a psychologist that works with trans patients is important, but the advice is about the same: research online (my local pride group has a directory of providers, I actually used the Trans in the South Guide to find my psychologist), and connect with community to benefit from word of mouth (talk to people and ask which therapists they went to, who they recommend, etc.).

I had to change my initial therapist because, even though she was trans affirming, she had never written letters or dealt with the bureaucratic process of patients going through surgeries - I needed someone with more experience because I was not prepared to guide them through that myself.

If you have to move forward and none of the recommended people work, you can always just take the risk and try to see a provider that hasn't been vetted. Worst case scenario, you can try to navigate this with heuristics: in my experience a provider is more likely to be safe if they are younger, queer themselves, and / or a woman. It seems like straight, older, and male doctors are more likely to be overtly transphobic (obviously this is not always true, these are just stereotypes to fall back on help guide you when all else fails - there are plenty of counter-examples, my endo was old and male, my PCP is straight and male, etc.).

Much luck to you dear, I wish you abundant gender euphoria in your future.