Sure. I am past menopause and take low dose hormones (more to avoid migraines and stay healthy than to be more ‘feminine’ but could take more, a lot of doctors do try to reach some level, mine does MHT not HRT ).

Middle-aged guys, yes, I think testosterone is certainly gender-affirming care, and there is no MHT equivalent for men, testosterone requires blood tests, you can’t just find the lowest dose that relieves symptoms, they always aim for some level in the blood. The Viagra/Cialis I think is more to correct for a problem. Or for recreation.