Hey there Cardinal

There are a few reasons for me not transitioning, so far...
I think the first and foremost is that the rest of my family does not know that I am trans, and I feel this pressure not to burden them with another issue. Having my sibling come out to them was actually not that hard, they were accepting (for the most part) and got my sibling on HRT and attended support groups, counseling, etc. But, that sibling has went off the chain mentally (i.e. stays in psychiatric hospitals, jail). It has created such a stressful situation for my family, that I don't feel they could handle another issue (e.g. Me coming out to them as trans). I know this is wrong, but I feel like I have to keep the rest of my siblings and my parents together, and the only way to do this is not reveal who I am.
In addition, despite them being overall accepting, i have got to hear the besides the scenes talk of what some of them have had to say about GID. Those quotes have played throughout my mind, over and over again. For me at least, hearing these quotes from my Father and other siblings, who you love dearly, is a real buzz kill on coming out. I just don't want to disappoint them. I don't want them to think of me the opinions they thought of my sibling behind closed doors.
Outside of the family situation, I am in Medical School going for a field where the average salary is $250,000. All that hinges on getting a residency, which unfortunately might be hard if I transition. A large percentage of my colleagues are very religious, and that includes the residency directors that select residents. I have researched other Transgender people who are in my field, and they have had a tough time making it. If I transition while here, I foresee myself being stuck with a $300,000 dollar debt with no residency, no job, and being very ostracized. I think that would ultimately be a lot worse than sticking through it and transitioning later in life.
Another reason, and this is a complicated issue, is that I fluctuate with my dysphoria attacks. Sometimes, all I can think about is being a woman, and being accepted socially, physically and emotionally. Other times, I am like, "What am I doing?", and I can function quite well as a man. So yes, I am still in the phase of being confused.
I actually have a hard time addressing my sister as my sister... And I hope like I don't sound too much like a hypocrite or a bigot with this. But, when I see her, her coming out and appearing female was embarrassing at best; I mentally criticize how she did the whole entire process. Seriously, I am thinking, 'That is not the way I would do it.' For example, she wore a female shirt and makeup to a Holiday Dinner. Okay fine, that is awesome. What was wrong? It had a gigantic Marijuana Leaf printed on it!! I was like, 'What is she thinking?!' That is why it is hard to address her as my sister. About 6 times throughout this she has shaved her hair, and for the vast, vast majority of the time I see her wearing Male clothes, acting incredibly male. In that respect, I hate to say this, I reason that maybe her GID is actually something else (she also has mental issues that span across the spectrum, so this is not too far off of a possibility).
Sorry if that was too long Cardinal