45 y/o here, been on TRT for 14 years (had test level of 318 at 31) - No prior gear use causing shutdown, my body just didn't make enough naturally

. I actually had to convince them that 318 @ 31 is actually LOW. I started with my PCP and moved through a variety of endocrinologists over the years. Currently with TRT Nation, because I'm very comfortable managing my own treatment after so long.
I will say that, ime, most doctors outside trt or anti-ageing clinics are looking for "in-range" vs optimal. My endos never liked my numbers getting above 5-600, but personally I feel best closer to 8-900. The clinics will get you to those optimal numbers but less handholding, so you should be comfortable managing your own care to a degree (I'm sure most of us on here are).
In my experience, TRT Nation is more strict than people elude to but they are still WAY more laid back than your PCP/Endo/Urologist, etc. will be.
Good luck, TRT made a significant difference in my overall well-being and hope it does the same for you (should you choose to go that direction).