Firstly, in terms of your health, you should of course quit and get sober and I doubt I even need to say it. If you need extra help you should seek it out, quitting can be difficult. Alcohol is quite harsh on a number of your organs and can give you cancer (which is much underestimated in the general population). If you're drinking enough a day, you may need medical observation to make sure you get through withdrawals okay. How much depends on your genetics and other factors, but generally if you're drinking first thing when you wake up and continuing through out the day that's about where you'd need medical observation. It sounds like you aren't drinking that much because you've been able to have sober days and even a sober month (congrats for that!)

The tests they'd be doing would be about your testosterone levels, your estrogen levels, and your electrolytes if the plan is to start on spiro. Alcohol and spiro aren't a great combo, it'll make you feel pretty weird. Alcohol can mess with your magnesium levels which in turns mess with your potassium, potassium is the one that spiro acts on. Spiro (spironolactone) is a potassium sparing diuretic, it acts on your kidneys to make you pee more but keep more potassium than usual. It has an off label use as an anti androgen. If they test your liver enzymes and iron - there's not really a reason to do it just for HRT - then they'd see how alcohol has been affecting your liver. When you've started on E, eventually you will be closer to how cis women are affected by alcohol. Yes it will take you less to be more drunk and it will affect your health more with fewer drinks.

I don't know if this is the case for you, but I've found a lot of people with a - let's say problematic relationship with alcohol tend to rely on it as self-medication for anxiety. Anxiety is also super common with trans people. If that sounds like something you're dealing with, see if you can get on something like an SNRI and/or getting a short term benzo as needed for panic attacks (if you have them). Those kind of psych meds do not play well with alcohol, one drink every once in a while is fine but every day would affect you way differently than you might be used to. You could, again if this is something that affects you, also seek out some therapy and get tools for dealing with anxiety in addition or instead of medication.

Quitting is hard but doable, you can do it! You made it one month before which means you can do it again. Peoples' bodies are generally pretty resilient especially before advanced age (think like over 70 lol). If you start picking up good health habits like limiting or quitting alcohol, eating a more balanced diet with plenty of fibre, and making sure you get at least 30 minutes of activity a day you will be in pretty great health in short order! There is no "too late to start" it will always benefit you ♡