I too was torn about going on HRT, but also felt I was coming apart at the seams and at the end of my rope. So I made an appointment with my doctor and a month later I was on HRT. By the way, I had talked with a therapist before the doctor's appt.
To say I feel better is an understatement. I have been on it for 4 months now, not a great deal of time, but the mental relief is well worth it. I agree with the others as I now have a calmness. I'm still in male mode 24/7, and my wife has asked me if I still feel the need to dress. I tell her the need is still there, but the urgency is greatly reduced. I'm not sure I can explain this, but the "noise" in my head is gone and I'm more at peace.
There has been some slight physical changes (my hands are softer and my nipples hurt which is kind of cool), but I still look like the same old guy. I want to go further, but the social price is so high (family, friends), so I'm not sure how exactly to proceed. My wife has told me, and I agree with her, that if I start looking too feminine, I will have to leave. The last thing I want to do is hurt and embarrass my wife, kids, and siblings. But I've also told my wife, I will not go off of HRT and go back to feeling like I was. The pre-HRT days were too mentally taxing.
Don't know if this helped and I wish I knew what the future held, but I do think HRT has saved my life. I don't wish for death anymore. PS: I'm older too, 57. You're never to old to take control of your life.