The big problem of the spout is there, adaptation, your T levels will be doubled, high T levels have consequences such as high blood pressure, among others, BICA is not safe in the long term in terms of health, we also have the issue of greater sensitivity of the receiver AR that the spout causes, the list is infinite the post would become giant, we need to be aware that this is used in the management of cancer patients in advanced states, they are not very concerned with preserving certain structures. The correct thing would be to get in and out, but I think it would go wrong, I think the approach with female hormones is safer than any other AA, you can control your T levels with E, and inhibit the action of DHT with 5ar blockers .
I don't see many success stories with spouts, but good luck, I'm watching your treatment.