VTBalla34: I appreciate the input, and you're probably right that I don't know as much as I should in order to drive my own treatment. I'm glad you wrote that post; you may be right that I'm putting too much faith in anecdotes and somewhat shady evidence.
Unfortunately, the docs that I've worked with so far don't seem to know very much about my issues, either, and I'm becoming fairly pessimistic about my ability to find a doctor that will work with me (rather than work 'on me', i.e. I want to avoid medical paternalism).
I absolutely cannot afford to see a doc outside of my insurance, nor can I afford to travel any major distance. The Mayo is about 2 hours away from where I live, supposedly has a good endocrinology center, and I am fairly certain that my insurance will cover it (I'll need to call to double-check, but I'm over 90% confident).
As for knowledge and research, I spent about two months looking in to hypogonadism while waiting for test results (blood, MRI, sleep test, etc.) without even finding this site, so I've looked at a fair variety of data and theory. While many posters on T-Nation do seem to be anti-doc (while at the same time being, ironically, paternalistic), there seems to be a good amount of solid information on here, and I have received some good advice (e.g. PureChance's advice yesterday that I only change one variable/medication at a time - which, while it seems obvious, is hard to keep in mind when you're as desperate for a fix as I am).
It sounds like I may end up trying my luck with the Mayo. I am fairly sure my current PCP (the one I am going to drop) would be willing to refer me there. Hydrojoe's experience sounds fairly crappy, so I'll be avoiding Dr. Carpenter, but I have to hope that there's a good reason for them to be a highly rated endocrinology clinic.
Plus, it'll get my SO off my back about going there (I kid, she's been extremely supportive throughout all of this)
Regardless of what happens, I know that I am already feeling somewhat better, and that in itself is a reason for me to be optimistic. This is day 2 after my second T shot (mistakenly did 100mg instead of 50mg, yadda yadda) and I feel like I am more happy and have more energy, more focus, and less brain fog than... well, ever before, to be honest. I am trying to be cautiously optimistic, since I know this might not last, but I do feel really good compared to how I usually feel.
I am desperately hoping that my metabolism kicks into high gear (fortunately, reduced depression has reduced my desire to self-medicate with food) because losing weight is a medical necessity - I am incredibly lucky to have no noticeable comorbidities associated with obesity, but I know it can't stay that way forever. I also hope that I'm one day able to get off of the anti-depressants, or at least the SNRI that is absolutely killing my sex drive and capability - unfortunately, that's also the one medication of the two that does the best to keep my mood stable (i.e. keeps it from dropping into 'suicidal' range for the most part).
Edit: and I just saw your post about working on E2 and cortisol simultaneously I'm not really sure what to do about that. I will say that the brain fog/forgetfulness/difficulty concentrating is interfering with my performance at work, which worries me. If fixing E2 will fix that, I may have to work on that immediately. I don't believe I'm in any immediate risk of losing my job as my company is doing excellently (god damn I wish I had bought stock when the market crashed... it hit $6 and is now in the mid-$20s), but I feel like I'm doing a mediocre job when I should be excelling - I don't intend this to be bragging or egotistical, but I am certain that I am a faster and more thorough programmer than most of my coworkers. Low concentration and energy, combined with brain fog, are killing my performance, though.