Samson, some people, like me, can go an extremely long time without any kind of medical transition. It's a struggle, and we hate living that way, but we're able to keep going. Then we hit a maximum saturation point and need to do something NOW.
This frequently happens when we're not able to be honest with ourselves.
I get the impression that you are on a different track entirely. You might be unaware of certain things that are going on behind the scenes, and you might not be sure of what you want to do, but you know what the fundamental problem is, and you're not making any sudden decisions. You might need quite a bit of time to figure things out.
I had lots of reasons for not transitioning. First I thought I was a sicko perv, and I was scared to death by the idea of transition. Then I started thinking seriously about transition, but the available literature indicated that I would be rejected for three reasons--two I could lie about or fudge; the other, not a chance--there was a heavy bias against gay trans men for a long time. And I had a great relationship and didn't want to jeopardize it.
Eventually, my relationship was the only real reason I didn't transition. When I finally got past that and was willing to risk my relationship--indeed, I felt that I had no choice because I was so desperate by then--I had to face personal fears.
Surgery was one of them. I didn't want to go under the knife. But I quickly got to the point where the fear was replaced by need. Once I had set up the date for top surgery, I mostly felt anticipation. Very little fear--a little nervousness. I just needed it so badly.
I can't say that it's good to get to that point. I got there by way of repression and denial. By then, I felt as if I had no options and simply HAD to have surgery, now now now. It was the same way with T.
I worked through most of this with my therapist and my then-new trans friends. And I did a lot of living one day at a time, one hour at a time, a few minutes at a time. When it's all you can do to just survive the day, something needs to change.