what helped me most with staying sane, is getting to know myself. i have some troubles that were just as bad, or maybe even worse, than the trans issues which i'm still not dealing with medically.
deciding/accepting properly that i'm trans and will transition when i feel like the time is right, makes it easy to put off for this time when the time isn't very right. has a lot to do with rigidity in national health care, but also difficulties finding a steady job. now i have a steady job, so rigidity is my only concern with that.
family used to matter, but finding out how much and in which way i want it to matter has made it easier for me to realize that i can transition now, if i feel like i have to. i'm still just wanting it really bad, but there's one person i still want to talk to face to face about it before i make a decision that is likely to throw me into a potentially harming system.
dealing with other problems than trans issues has helped a lot. to a very large degree, i put off the serious efforts to transition so i could find myself first. i have too many issues related to my mother. i've dealt with most of them, by learning how much damage she and my not daring to stand up for myself, has done to me. there are problems with my behavior, anxiety, depression.
depression is gone now, anxiety seems to return only out of old habit. i know who i am, both the good and bad sides. there's still a bit left to work on, but i'm overall happy and living my own life.
and then back to the trans issues. the feeling of wrongness return often. some times like an annoying fly, that's easy to live with. even just changing clothes will make me breathe more easily when it's not too severe.
but when it gets hard, i will lose sight of all my plans for the future, i start questioning myself, forget to live in the now. i cut or dye my hair when that happens. when i can't stand to see that same familiar totally wrong face in the mirror, i change a most noticeable detail. it won't change my gender, it won't fix my body. but the face is different, and it gives me time to sort out the things i want to sort out before running head first into transition.
notice that i use want instead of need. i've finally gotten to a point where i don't make choices out of need (or feeling of impending doom, anxiety and depression are not to be trusted, neither are family), but out of my own will. i no longer have insecurities about whether or not to transition, i know it's right for me to do it. the only question is what time will be best for me to start a process that i know i might have to stop because it could take me in a direction that is wrong for me.
but i'm happy. more me than ever before. sane (probably). managed to get here without a therapist, but i've had good friends helping me. some here, some at another forum. interestingly i got help to stop fearing the possible consequences of transition from normal people at that other forum. it's a place where i can be the gender that i'm not yet offline, and the few people who know me as trans have been mostly accepting. one was not being too nice about it, but others would tell him off. gave me back faith in humanity.
and the people here, with all their life experience, have helped me come to terms with all the other things that have been troubling me. first it was accepting that i'm trans, but in my own way which is a little different from the norm. then it was accepting myself as an imperfect being who still deserves just as much love when i fail as when i do great. never got that from my parents, but that's because they're imperfect beings too.
anyway. trans isn't a big issue that steals away almost all of my mind's capacity. it was for a while. transition seemed like the only cure for my life, and one that i couldn't even get. by dealing with all the other issues i have, i lessened the gender dysphoria as well. i don't hate my body, i just find some parts of it rather useless. there isn't anything i'm so anxious about that i feel like i have to fix something in order to survive. so the need to fix my body disappeared. now i just really want to fix it, and that's something i can live with. i can even feel generally happy without transitioning, though i believe i'll feel much better about my body, and possibly even happier if i do that too.