I came from a really conservative family. They all wanted so many things from me when it came to behavior, beliefs, etc. so it was hard, really hard to come to terms with what I am due to the fact that I knew, no two ways about it, what would happen if I ever moved towards 'transition' (a word I didn't even let myself know.)
I came out three times, and then immediately 'boxed' (repressed) the memories of them, over and over again. I struggled with it in my mannerisms and day to day life. It would pop out and I would do what I could to push it back down.
As every girl like me does at some point, I finally lost the ability to play dumb/deny/whatever and so, *bam* there I was like a newborn babe just shoved into the world. I *completely* lost the ability to lie about it. Overnight. There was no 'transition' for me in that way. I just hid in my room for a couple of months while my brain did its thing and then, I came out and was whole but very raw.
For the first six months to a year, I was so relieved that I didn't really do a lot of introspection and reflection on being trans or whatever. After that though, I started wrestling with how much easier it would have been if I'd have not came out or how the hell I have a female mind here in this body which bends the wrong ways and feels a lot wrong, all of the time (hormones only help so much.)
Over time, I had to simply experience life as myself to come to terms with it. Being myself all the time, no matter what is very validating. I had to experiment and grow as a person (I have a whole rant on delayed maturation of a trans-woman's personality that I could get into but I'll save it). I tried new things, new people, and really felt it out as to whether or not I was being 'genuine' or 'fooling myself'. Day by day, my certainty grew and my doubts went away and, over time, it went away completely.
I'm still not completely comfortable. I doubt that even post-op will change the fact that my body feels... 'off' but I have become comfortable in who I am as a person, through and through and that's the essence of 'acceptance'.