I think that an important dimension of this discussion is that most of us are both IN and OUT, in the sense that our OUT world is fairly limited and for much of our life we have to hide our cross dressing selves from substantial segments of friends and colleagues.
So we are leading a double life and I have read stories of people whose careers demand that they lead double lives and they have talked of the stress this imposes on them. Think of some classic espionage agents who had to completely compartmentalise their world and not allow anything cross from one part to another. What does this do to our mental health?
For example I have neighbors who have expressed a dislike of cross dressing and so I try to keep my cross dressing self away from them. In almost all other respects they are good neighbours and I value them. Or the time I was having dinner with some close friends who do not know that I am a cross dresser and the woman began to describe the problems she was having with one of her employees who is TG and is starting to "come out" at work. It was awkward for me as I wanted to be sympathetic to the person but I had to limit my sympathy to some rather anodyne phrases and comments. I suppose that I could have said that I was a cross dresser but I don't think it was the appropriate time for that. Was I being cowardly?