I've spent a lot of time going back and forth with this myself. Part of the problem is that I feel like I haven't had a choice in a lot of ways, especially when it comes to being trans and needing to be seen and treated as myself, a woman who just happens to also be trans.
I think our choices come into play when we are deciding how &a when to come out, transition, our new clothing style, etc.. The choices are smaller in a lot of ways, but my choice to transition was mostly just my survival instincts kicking in. I knew after hitting bottom that the only way I could go was up. I figured I'd try before I gave up on everything.
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