Another way to keep most of the dissipation off-chip for an HF transmitter would be using low voltage nmos devices on the chip, providing differential open-drain outputs, each driving the emitter of external cascode (common base) transistors (e.g. BFQ262 from an old CRT monitor) with their collectors driving each end of the centre-tapped primary of an output transformer, with the centre-tap to the HV supply.