Most people don't have to think about their gender. It is an unquestioned part of their identity but we gender dysphorics need to keep examining our situation until we can come to an acceptable equilibrium; one that allows us to live with a certain level of mental peace.
Coming to a workable resolution has allowed me to sharpen my senses and bask in the positive energy that this has brought me. In male mode I perform better at work and I am nicer to people in general. Joanna is happy when she goes out and interacts much more than she used to. She doesn't worry about how she is perceived by others and as a result is perceived to be a genetic female all the more.
Removing obstacles that prevent you from treating your dysphoria is pivotal. We are often our own worst enemies and we tell ourselves we will be rejected or scorned and yet I have found the opposite to be true. If you present as a lucid, caring and confident person, people may care far less about the wrapping you come in and focus instead on the real person inside.