HRT definitely has subtle but massive consequences, but you're saying you're not able to be a realist any more?
Maybe it's more like what I experienced in the first "half" of my life, which is I was able to see different facets of the same reality simultaneously.
As an example, the value of human life. I was able to see it on multiple levels - precious to the individual, precious from a perspective as an individual life is never repeated in the exact same way, inconsequential to the bigger picture because there are countless lives waiting to come into existence which might be just as interesting or productive, meaningless and worthless to an expansive universe, the nihilistic view, the romantic view, the pro-life view, the pro-choice view, etc. I held them all at once, particularly the idea that life has value because it's unique, but only to us, and particularly mine to me because it's the only one I've got. Since I live in the human world more than I think about the bigger picture, realistically I go with the idea it's generally worth preserving. But you can have a ton of perspectives on something and just select the right one for the moment?
I'm still like this on T, but I notice there's a slight change in that I'm not inclined to think as deeply about all the levels and just go with whichever one is most logical. But before I would look at many facets more. Thoughts were less focused than they are now on E. Not worse or lesser, but they did take more time to sort through, and they were more intrusive as I was going about my day.
Probably normal for females. More than one has told me they like the fact they see different perspectives at different times due to hormonal shifts. I don't know how radically different those perspectives were at different times (mine weren't much) but since they mentioned it, I assume it's fairly common. I think you can still be a realist, you just don't have to worry about being extremely rigid in your thinking. For you it'll probably be a relief to find you can relax a bit with it but it'll be disorienting due to life habit. For me, it's the other way, I like the clarity of being a bit more focused and not having my mind in several places at once.
So you don't have to think of it as a lack of reality. Just maybe looking at the same reality from many angles. It's just as valid, isn't it, unless we're talking maths?