Interesting thread Brenda, love it
I fully agree there is a difference, its subtle, because the wants and needs can blur and become the same.
I have known I have been a female in a male body for 50 odd years. Because for a massive proportion of those years I could not become what I knew I should have been and wanted to be; I managed it and tried to be wholly male, inside it was eating me up... but it was managed. Could it still be managed; possibly, but I want to transition, I need to transition because I do not want to die unfulfilled...
Need is driven by something; a burning desire, a condition, forced to do something, timeline in a series of events to meet a final point... Want is an; I wish, have a choice but want it, seek the unattainable... I experience both and juggled these in the past.
Most of us want to become a woman/female/girl, some of us also have certain needs too; if I don't I'll destroy myself... often the want drives the needs e.g. I want to be female, to do that I need to do etc...
Over the last 20 years the drive to become female has become almost obsessive over the last few years, so I went on HRT just over 10 years ago (slow process at my age), am I ready to fulfil my desires, nearly there from being able to look who I am, I do need to still do some feminizing things... but above all I need to come out. The latter has now become almost 90% consuming of my thought processes... So I want to and I need to... there are alternatives... I have to qualify these too based on level of inflicted pain on those that are closest to me.
So I have always wanted to, I knew at some point that I needed too... Its here!
For those that want to but have doubts, do need help... but having said that only you know who you are and want you want. So you need to determine either now or live a life of wanting to!
By the way Sorcha your therapists seem to have been blunt or flippant.... early on
GRS/SRS are of course a matter of choice, Gender ID on state documents are a must, unless you are lucky enough to have been given a unisex or female name, else you will always be the target of others and if you travel a lot you could end up in an unfriendly country where tolerance is just not there...
Just the thoughts of a person with 90% of her mind somewhere else

L Katy