It's far from as simple as them saying "I'll prescribe the minimum dose proven to affect suicide rates among trans people.". A lower value also is better for mentally unstable people (like it was for me). Yes I also feel better when I double my Ritalin dosage but you also shouldn't do that of less works fine too.

One approach says, "trans identities are valid and I want to help facilitate them as best I can." The other is, "trans women are at their core delusional males.

That's complete bullshit except if your doctor is ass. If anything, they won't give more E than 200 because they don't want to be a possible liability since it's understudied. But guess what, you can also just take more yourself if you don't think your doctor is right.