Funny story, I am transgender and considered male at birth. When I was younger, I tried seeing a gender therapist so that I could get HRT. HRT wasn't offered on an informed consent basis in my state, so I needed a therapist letter to bring to the endocrinologist. The therapist was a elderly, white, gay cisgender man who had been doing this for some time.
First question on day one is if I wanted breast implants. I said no, in addition to privately finding it kind of dehumanizing he would start by going there. I saw him a significant number of times, while being charged all the while, and it did not go well from there (eg, not being attracted to men or wanting to marry a man was also the wrong answer). Eventually I realized he was never going to approve me or give me any time of timeline, so I had to travel out of state on the greyhound bus to find someone willing to do it on an informed consent basis. Once I started the HRT, I had to do the bus for follow up appointments every 6 month I believe, which took a full day.
I saw older transgender women talking about having to lie, show up to appointments in high heels, etc. I'm lucky I'm not any older than I was because I would not have been willing to misrepresent myself, even to get access to medical care. Of course, I don't blame anyone for doing that, but I especially wanted to be honest about this.
Anyway, I am mostly satisfied having smaller ones as it seems like it's easier. If I had the ability I would go slightly larger, but I use the silicone bra inserts and I am satisfied with my figure that way. Anyone who had an issue with this would not be someone who sees me without the inserts. I much prefer the inserts to having silicone in my body, at least, especially since it would need to be surgically replaced periodically.