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Before undergoing mtf or ftm, the doctor may suggest doing some tests. 

Tests for mtf

• Hormone level testing
• Pelvic exam
• Breast exam
• Prostate cancer screening

Tests for ftm

• Hormone level testing
• Pelvic exam
• Breast exam
• Cervical cancer screening

Other than the tests, the healthcare provider may give certain instructions. For example, if you are planning for a hormone therapy, you may be given instructions on how to take the hormone medications and how to monitor for potential side effects etc. And in case of a surgery also, you may be given certain instructions on the diet you need to follow, and which medications you should take or not take, etc.  

It is important to work closely with your healthcare provider and follow all the guidelines and instructions given by him to have a smooth transition journey. 

It seems like you may be going through some changes about turning into the opposite sex. Understand that these changes are complicated and might need some medical interventions. You might require different amounts of hormones to help you through the process. Talk about what is bothering you and your symptoms with a doctor who can help you figure out the best way forward.

If you don't take testosterone or undergo top surgery, you can still build your pecs by lifting weights. Pecs, short for pectoral muscles, can grow with exercises like chest presses and push-ups, which target these muscles. Pace yourself, use the correct form, and be consistent with your workouts. Your pecs can still develop even without testosterone.