Your doc probably figured this out already but mention it anyway the next time you see them.
Oral estrogens undergo a first pass through the liver before entering the bloodstream. This leads to a rise in inflammatory and procoagulant factors with a resultant increased risk of DVT. However, transdermal patches and estrogen injections (IM or sub-q) enter the bloodstream without passing thru the liver first. This is good news for anyone that’s at increased risk for clots. I’m using injections because I have a blood disorder that increases my risk of clots. There’s no way I would do pills. Don’t give up hope.
If you get the green light, find a good endo with experience treating trans patients. There are way too many docs out there that don’t know what they’re doing when it comes to trans medicine.