When I attended the Southern Comfort Conference in September I saw every combination possible. I saw MTF's that were living as females and did not pass while other MTF's made me jealous.
Most of the MTF's made a great effort to look like and act like a female and I thought they were very passable.
If a person wants to live as a female and is happy in spite of not passing then more power to that person.
Personally females are beautiful and I think it is worth making an effort to at least try to be beautiful.
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My wife turned out to be the 1 in 20 that accepts her husband. It has taken her a couple of months to get used to my body but she has become a very close friend again. It also took a second conversation for my wife to understand what I told her the first time (6 months earlier). Our arrangement is I can express myself in our bedroom but she discourages me from telling the children so that she remains the only person that knows. She is shocked at my gestures, emotions, and massive reduction in muscle mass. She has even given me an occasional compliment related to my female side. However she knows it would be very difficult for me to pass even with help.
I only dress as a male when I leave the house. Yesterday 12/4/07 I was chatting with a good neighbor friend whose son also plays on the same varsity baseball team as my son. I got the same comment I have received from many people, "You look very good! What have you been doing?"
Do you think I should tell my neighbors the secret to regrow some of your hair?

I am quite paranoid and do not relish the idea of people making fun of me behind my back.
My wife is quite funny and she told me that she has prayed to the Lord for the past few years for me to return to her. She did not realize that her prayers would be answered in an unusual way. I told her yes you won the "boobie" prize!
I am happy my wife stayed with me. Nero I can not answer your question at this time. If my wife left me I would feel less pressure to worry about passing. Now I am worried about my wife losing all her friends because she chose to stay with me. I think circumstances can influence the decision.