Self medding is not scary. Buy the meds, start a small conservative basic dose. Like if your pill is 50 mg, cut it in half and take 25 mg a day for a week. Then the next week, take the whole pill for 50 mg, daily. Then the next week take 75 mg. And finally get to 100 mg. It's not perfect, but it works to test body effects. Then after a month, I started E. After that, it's smart to get a blood test to see what each medicine is doing to your body.
As for risks, it's good to not drink too heavily or smoke cigarettes while on HRT. For MTFs, spironolactone is a potassium sparing diuretic. This means that you're going to be taking in a shit ton of potassium, so you have to lay off the bananas and avocados and things like that in high doses. It also means you're losing lots of salt due to being a heavy diuretic. So you need to take in a bit more salt in your diet too. Plenty of water helps things moving too. Anyways, the potassium stocks up in the liver from spiro. Hence why alcohol use should be curbed: because the spiro passes through the liver and weakens it. This is why a lot of MTFs take pills sublingually or even injections: to bypass the liver. Never mind the effects spiro has on your kidneys, especially without plenty of water. A few drinks a week is fine, but going overboard can fuck you.
Other risks include blood cloths, but that's often overblown assuming you're young and healthy. But it should be repeated that cig and alcohol use can increase the likelihood dramatically, particularly cigs.
It's not really scary at all. We are a tight knit community, and there's a ton of resources for trans people who self med and what to do. Assuming you're not dumb and take like 16 mg of E a day, self medding is fine given that you have your health (levels and body functions including liver, kidneys;etc) tested. For a lot of people, self medding is the only option due to gatekeepers.
