Wow, pains me to read this and at that same time reminds me I am not alone.
I feel completely in the same boat as you,Kirsten and Emma. I'm continuing to move forward, but not sure that I can handle going all the way forward either, only thing I'm sure of is not wanting to go back. I constantly get melancholy that I will probably never change enough to accept my self-image, and yet relieved that I can maybe continue to push on in the male life that will satisfy my close family, with just this hormonal balance shift if I have to. I realized that I never like my self image post puberty anyways, hard to imagine it being worse.
I'm often wracked with guilt that I pass my pain onto my own family and risk what by all measures has been a good and fulfilling life, that I just am somehow left unhappy in. It's scary, my wife has been my best friend for nearly 20 years. I'd venture to say my only friend, everyone else is an acquaintance. If she leaves me, loneliness is guaranteed. Fortunate enough to know that life goes on one way or another, and having witnessed a parental suicide's impact on a close friend growing up, I have the realities of who suffers firmly rooted in me. Guess I'll just have to own a lot of cats some day.