Almost four years ago, I was trying to fight this thing yet again. I found a gender therapist and when to him to help me stop this "demon" out of my head.
We talked about my past and the things I had done transition-wise and why I had stopped. He suggested that I "go out with the girls" once a month to help quiet the voice. Like that would fly with my wife. So I tried to just be the "man" that she needed me to be. A year later I tried to take my own life.
It was then that I knew I had to transition, period. My wife and I sold the house and went our separate ways. I sought out the same therapist.
At our first meeting , I asked if he remembered me. He said yes he did and then he said some thing that told me I was finally on the right track. "I knew you would be back. It is obvious that you are Transsexual."

Most gender therapist will use the first meeting as a "getting to know you" meeting. Then they will get down to business.