In my experience, I tried very hard despite severe dysphoria, to maintain my male life. I didn't want to risk my family as I believed I would never pass as a woman. I succeeded until the years of stress destroyed my health, and my doctors said I needed to transition or risk death. Even then, I initially chose to take my chances rather than face the prospect of losing everyone. It took strong argument from my doctor and ex to get me back on hormones.
But I have a different understanding of my condition. I don't see myself as male or female, but a person with a part of my brain which causes gender incongruence, and subsequently, dysphoria. So I didn't feel I was pretending to be male, I was, and still am, just me. Early in my life I recognised that I had something which caused me gender incongruence, and I only ever wanted to be rid of it. Medically transitioning almost achieved that, so my goal was achieved. Social transition simply cost me more than I was willing to lose, and it was made more challenging because I never saw myself as female, so I didn't have a social goal. In retrospect, I think hormones and GRS would have reduced my dysphoria enough, and maybe I didn't need to socially transition, but my surgeon had a requirement to be living as a woman before he would operate.
Hugs,
Allie