I agree about the worries with transitioning and the wish for a simple body swap. I would be a very tall and quite manly female post transition. There's a lot of wishing involved in this for me (ie wish: started sooner, wasn't so tall, could be easier, was born with the correct body!). I'd recommend, think it over with yourself, play some scenarios through and see what you think. If you're feeling particularly ambitious, maybe even bring it up with the therapist. I don't know how well versed he/she is with gender issues, but if it's something that has occurred for this long, it's not going away and it's not something to give an incorrect impression of you (on the inside I mean). Mentioning it is not a commitment to transition, and if your therapist tries to force you to that, they're a terrible person. Try saying it out loud in the car and see how you feel. I've tried looking in the mirror and saying it and passing my own tests before telling my therapist. It really felt good to talk about it, though.
I can see that there is a lot that is troubling you. I'm glad that you keep checking here. Stay strong, you can do this.