It's been awhile since I've been here, but I wanted to add another voice.
For the longest time it's been Fear, Doubt, and Obligation. And the last ingredient is a sad sense of self-hatred, which I peeling the layers away from and almost at a breakthrough.
I won't recount my past history, it's here on the forums when I first joined, but loosely I was mistreated early on and groomed to be something I was not. The motives to get me were for their own reasons besides love (they being the parents). That programming did some damage and it's been a personal work to pull through. I feared what would happen if I tried to pursue transitioning, feared how it would affect the family, my friends, and the future.
On that end I dispelled some of those fears; my friends love me no matter what (I won't know fully until I begin the process, but it's a baseline), the ones who were confused or repulse kind of faded away. My parents showed me a glimmer that they don't accept me when I came out to them, and the reinforce (consciously or not) female terms or terms related to what I do for them, but not really a genuine sense that I belong. It's complicated there.
Obligation to care for them in their old age. I figured I could hold out longer and do what they needed me to do (the programming).
Doubt and self hatred came when I started to investigate some principles of Buddhism. The last few years were silently rough between the beliefs and myself. I could not and still don't have a way to reconcile who I am with certain teachings.
Another part of self hated had been a misdirected hatred at men an their privilege, the things they can do and get away with, and other really silly things that just didn't make much sense thinking on it now. It really came down to the fact I hated who I trully was and forcing myself to deny that. I was angry at the fact that I was stuck in this body with all it's faults and no one could see what I trully was. I hide behind the internet, because I can express my true self without anyone seeing the real pain I'm going through in the natural world. I don't know if that's coming out correctly...
In the end, as of today, I'm almost finished with a breakthrough. I realize caring for my aging parents is taking away from the time and energy I could be putting towards getting my life started, on track and on the road to healing. Hating who I really am is denying me the chance to live authentically, and denying people the chance to another one, among many, person in this world.
My health is also forcing this to the forefront as a wake up call. I realize sometime this year I may need a hysterectomy for reproductive issues I've been trying to "bear up". I said to myself, " I get a hysterectomy, it would be no option to have hormones in my body for my general health. And If I have to take hormones for the rest of my life, I would rather have testosterone and have therapy to deal with any issues related to my fears, than to forgo any and live in poor health, unhappy and bitter at any and everything."
All the fear, doubt, and soon obligation will completely crumble into dust, and new path, person, time period is going emerge. I'm ready for that.