Thanks, y'all. these responses really helped a lot.
i guess i am just used to shoving my personal feelings aside and calling them irrational, and avoiding doing anything that feels pointless. But in an effort to take my own comfort into consideration, even in a small way, i decided to go ahead and buy a new binder. I was going to try on my old one, but it seemed too small, so I went ahead and ordered one that will hopefully be the right size (not to mention a better color lol).
I realized i already sort of do this with other aspects of my appearance; years ago i stopped wearing all the frilly things and women's clothing and switched to men's clothes, and even without any hope of passing i haven't gone back to wearing women's clothes. So why worry about whether or not doing other things for myself will affect how i'm perceived?
I agree that doing little things to make myself feel better has helped, even if they don't entirely "fix" the problem. So i guess i have no real reason to avoid them aside from years of conditioning. But maybe the more small steps i take, the easier it will be to live with this and let go of all the fears and start putting myself first. Maybe eventually i'll start seeing myself as a person. that would be nice. I'm really tired of feeling like a nothing/in-between all the time, so i guess the least i can do is not treat myself like one when i don't have to. It's just really, really hard to accept.
I have at least a couple of (mostly online) friends who know my situation and accept my identity, but no one that i see on a regular basis. Because of my situation (things like transportation, money, and location), I don't have much contact with people aside from family who doesn't support me and coworkers who don't know but probably wouldn't be keen on supporting me either if they did. i don't get to go out much, though I'm working on getting my driver's license. it's just very hard right now because with my schedule, i can't get in enough time to practice driving to be able to pass the license test. But hopefully when i do get that done, which should be by the end of this month at the very latest, things like support groups or something will open up to me as options. Having a couple of friends i can sometimes talk to about things is nice, but there's no one I can really see and communicate with in person who has similar experiences or helpful advice on these matters. I never really wanted to be in a support group, honestly, but as time goes on i start to think more and more that being able to share with people that i can actually see and getting to know people outside of my almost nonexistent social circle could be a good thing.
As for weight and health concerns, i had considered PCOS as a possible factor when i first started having the weight gain problem, but my mother totally dismissed it because I wasn't growing a beard, and I figured that even if that was the case, there was no treatment except to be put on birth control to give me a more "normal female" experience anyway, and I definitely didn't want that. I'm not sure what happened with my weight, exactly. I got off of a hormonal birth control implant and got put on a new medication for autoimmune disease at around the same time, and was also under a great deal of stress. Gaining the extra weight so suddenly and rapidly, and having everyone i talked to just blame it on me when I knew it wasn't my fault, of course only added to the stress. I was threatening to quit my medication and risk being put back in the hospital by the time they finally took me off of it--and they didn't do that because of the weight issue, but because the stuff they had initially put me on was no longer working properly. As soon as they changed my medication, i lost a lot of that weight, so i could only assume the medication had been the cause all along. But i'm not really sure; all I know right now is that I'm having trouble getting rid of what's still left of it. Everything else (like loss of period and extra hair growth which happened due to the weight gain) has since gone back to normal.
I know a couple of other people now who swear by the low-carb/high-fat kind of diet. I don't know how well I'd be able to manage it with my Crohn's, since it prevents me from having things high in fat or fiber most of the time, but I'll do some more looking into it and try to see what kind of dietary changes I can make to help facilitate weight loss... because counting calories and having a physically demanding job hasn't done anything but leave me hungry at the end of the day.
i know i keep saying it and not doing it, but exercising a little more on my days off would probably help me out, too. even if it's just a walk or two around the block. i know this, just like i know taking the time to complete projects instead of leaving a bunch of unfinished work laying around would also probably help me feel better both inside and outside... it's just one of those things i really struggle finding the motivation for in the first place.
Any advice on getting motivated--and not letting myself be overwhelmed by loneliness, boredom/apathy, or feeling like i have too much to do and not enough time to do it--would be appreciated, as well.
I also really feel like i NEED to find a doctor so I can start getting treatments. Like the other stuff mentioned here and just doing little things in the meantime to make myself feel better, this is one of the things I know I can't be happy just waiting for. I'm tired of putting it off, even if the reasons for waiting are legitimate concerns like time, transportation, and money. I will have my license soon, and even though I'd be VERY afraid to drive across the state to see a doctor, going into unfamiliar territory and being completely alone for a very long drive over highways and whatnot, i don't think I can/should just hold off until I live closer to the clinic. I need to find a way to actually make an appointment and get there, because even doing little things isn't going to be enough. It might help, but i need to feel like I'm actually ON the road to making progress before I can accept that I'm "just not there yet".
I don't know if it would be better to go by bus and stay in a hotel overnight, or to brave driving by myself. I also don't know if there is anything closer to me that I'm just not finding, or whether i should trust whatever I do find if it's that much harder to dig up than, say, Planned Parenthood. PP is the only place i know of for sure that offers that kind of treatment, but it's very far away.
Another thing I considered but am not sure of is seeing a therapist/counselor specifically for gender-related issues. I feel like i've already talked the issue to death between myself, my closest friends, and a previous counselor i spoke to for other reasons who brought the gender thing into the foreground when she realized it was a likely contributor to some of my problems. I've been aware of all this stuff for years, and I have no question about how or whether to transition. I don't know if there would be any point in paying a therapist to talk about things I've already known and talked about for so long; I'm not questioning any of that now. I just don't know how to access the treatment I know I need, and I wonder if a therapist would make that easier for me by being aware of resources that I have yet to find on my own. PP does informed consent; a letter wouldn't be necessary. While having someone to talk to would be nice, a therapist isn't really a friend... but maybe they could at least be a resource. I just don't know if it would be worth it for that.
Breaking things down into smaller steps definitely helps, though some things I'm not sure either how to tackle them or whether they should go on the list at all.