A: Even for menopausal women, oral hormones should be avoided because of the clotting & stroke risks they particularly carry compared with non-orals, due to passing selectively more through the liver, but in the trans woman, where the doses are significantly higher, this is urgently true, & to a far greater extent.  In addition, oral HRT reduces feminizing potential and selectively fuels edema, depression, weight gain, pancreatitis, high triglyceride levels and gall stone formation.  And alternatives are easily available.