My post history has some context for people who are curious or just don't know what I'm talking about.
Recap TL;DR: I came out to my wife and she was afraid that if I transitioned she would stop being attracted to me. Since I was afraid of divorce, I decided I'd hold off on transitioning indefinitely.
Since then, my wife and I have been bouncing all over the map this week. She was freaked out initially, but then she flipped to being ok with me transitioning - with the caveat that she might not be attracted to me, but she'll always love me. With that in mind, I felt comfortable looking at what transitioning might really look like.
One reason I wouldn't ~~transition~~ start HRT* anytime soon is fertility. I want more kids. I love my child and I want 1-2 more (as was always my marriage's life plan). I know freezing sperm is an option, but in-vitro is so expensive I don't know if we would want to try it. I realize kids are far more expensive than in-vitro, but my wife and I have budgeted for kids - not kids + in-vitro. We have plans to fix up our house, retire early, etc. So I don't want to put undue stress on those plans. We are considering freezing sperm, but not very seriously.
Also, based on some messages I got from users, it seems like having kids prior to transitioning is a contentious concept? I didn't expect that, but some people (mostly in DMs) seemed angry that I didn't know I was trans until after I had my first kid. I think those perspectives are related to divorce since divorce does produce worse outcomes for kids (generally not always). I guess I'm inviting people to come here and elaborate on their thoughts about that.
Anyways, I struggled to hear the harsher words from some people, but I also think they were well-founded. They were a gut-punch that made me reorient my thinking away from selfish thoughts about myself and more about my family and how my choices impact them.
I built up transitioning in my mind. I was feeling a strong sense of dysphoria. I assumed my wife would be ok with it (since we are already inhabiting stereotypical reversed-gender roles in almost every aspect of life). I assumed it wouldn't impact my fertility so quickly/drastically. I thought I was a month or two away from starting HRT. But the more I research it, the more I think I could be years away.
As an attempt to take this slower and more seriously, I have an appointment with a therapist today to start. It really should have been my first course of action anyways. It's possible I could start transitioning with non-hormonal techniques and maybe that's enough for me. If so, that would be ideal. My male physique wouldn't change too much and my wife would be happy about that. Maybe my dysphoria would go away. I've tried that in the past, but I didn't go "all-in" on it. I felt ugly and manly which bummed me out back then, but maybe I just didn't really accept myself and that was hindering the experience.
Generally speaking, I think I was just moving way too fast and unmeasured. I'm assuming that's common in "TransLater communities" because there is a lot of fear that the biological clock is stripping away my opportunity to meet my goals before it's too late. But that doesn't mean it's the right mentality. Plenty of people transition much later than I was planning and it works out fine. So, maybe that'll be my experience. Or maybe I'll never ~~transition~~ start HRT* due to the aforementioned options, therapy, etc. Who knows. I'm probably still going to be active in this community, if that's ok. I sure hate that my whole experience is practically the only thing in this community lol It's a bit embarrassing in a way. Please drown out my posts with some more positive stuff!
Trans people have kids all the time. The current attitude is to assume HRT will make you infertile because that's a good best practice, but the evidence currently points to higher probability that you regain fertility when you pause HRT than not. (It's actually a common misunderstanding that HRT permanently kills fertility, some doctors don't even realize fertility can come back, let alone that it is probable.)
I understand the concern about costs, but if you are thinking you can afford to have kids or transition at all, you can certainly afford fertility treatment. Based on what I've read, it's a thousand up-front and a few hundred per year afterwards. Kids are much more expensive, as I'm sure you know, and transition itself is usually more expensive (hormones are cheap, but the surgeries, hair removal, etc. all cost more than freezing sperm).
Another option of course is adoption, if what is important to you is that your daughter have siblings.
I do think therapy is a great idea, given the therapist is trans-affirming and has experience working with trans patients (and has a PhD and is qualified, like you said).
To my perspective, there are plenty of options for having more kids and it is essentially not a blocker to transition, especially given the significance and importance of alleviating dysphoria.
If you knew a dormant cancer was on your testes, that this cancer doubles your risk of dying and will make your life miserable, and that treatment is proven to make you much happier and significantly decreases your risk of dying but might make you infertile, would you remove the tumor? Would you listen to your wife if she told you not to remove the cancer because she wants to have more kids (or because she's afraid she won't be attracted to you anymore without those genitals)? Relevant to this thought experiment is also that the fertility treatments to store your sperm will cost a fraction of the larger costs of having the tumor removed, and of having more kids.
I can't help but feel it is only because we live in a society where transitioning is not accepted, where trans people are not well understood and are stigmatized, that it seems reasonable to delay treatment and accept the increased risk of mortality to appease others' anxieties about the treatment.
That's why it's not surprising to learn that trans people have double the mortality rate of cis people and have a median life expectancy seven years shorter than cis people.
It feels unclear because you are not in a neutral or supportive environment (and your needs and well-being are not being taken seriously). We all go through this, I went through this. As a result, you may not transition this time, or you might not ever transition. Looking back, I've been trying to get people to let me transition since I was 3, even without awareness. I've tried over and over and over again - the environment was never supportive until now. I only transitioned when my spouse wanted me to transition, and when it was finally clear to me that this was also what I needed to do so I can be a healthy, responsible person in the world. It doesn't happen for everyone, I suspect it doesn't happen for most of us.
The studies found gender transition is the only effective treatment, not just HRT (the studies looked at improvement of well-being from socially and medically transitioning, including effects from gender-affirming surgeries).
No therapy or drugs have been found that eliminate gender dysphoria (and boy have they tried - the conservative, transphobic medical establishment did not exactly start with gender transition as a solution). Some anti-depressants have shown to mildly improve some of the symptoms of dysphoria, but this is not really comparable to the changes seen with medical transition.
I consider any therapy designed to help trans people live without transitioning (i.e. to "live in their assigned gender") a form of conversion therapy. A lot of people don't understand that conversion therapy is not just when they torture you, it's also when talk therapy is used to treat dysphoria.
Good luck in therapy - I'm rooting for you ❤️