Never not thinking about Lou Sullivan's mom, Nancy Louise Sullivan — a homemaker in a devout Catholic family, raised 6 children in the 1940s-70s iirc. Never did transition, but was very supportive of Lou.

there are more trans men and transmasc folks who lived and died as women than the world will ever know about. i cannot tell you how many stories I've heard of people's mothers and grandmothers telling their trans kids and grandkids that they probably would have transitioned if it had been a real option for them when they were young, because there's so many that counting would be pointless. Not just to escape womanhood, but because they wanted more than anything to live how they felt comfortable without judgement from their friends and family. And because they knew they couldn't do that without being ostracized, they gave up and conformed to expectations as best as they were able to.

The sunk cost of life as a woman is the main thing that stops them from transitioning as adults. Marriage, kids, the exhausting process that is going through a second puberty, the expense and physical strain of something like surgery alongside having every choice they've ever made held against them. They know transitioning means their husbands will most likely abandon them, their kids most likely won't support them. Loss of friendships and the supportive spaces meant for women, despite having lived as a woman for decades. And most people can't take that kind of total societal rejection.

also want to add to this conversation that Matthew Shannon's study of the USTS data found "a negative association exists between income and MTFs who transitioned to female earlier, and FTMs who transitioned to male later," meaning trans men who come out later in life are more negatively economically affected that trans men who come out earlier in life.

and being a housewife in a conservative environment is pretty important here as well; both anon's Mormon friend and Lou's mother were in a culture where the pressure to be a wife and mother were very strong and the expectation to get married and have children as soon as possible is heavy. in many cases (historically in the US and historically and presently in other places) people classed as women were legally discriminated against in terms of having a bank account, getting a credit card, taking out loans, or even being able to travel without a male relative. and that last one also IMMENSELY limits the ability for transmasculine people in such regions to organize communally as well.

so a trans man in this environment is in a situation where he is the primary caretaker of a child if not multiple children as well as performing the duties of a wife, having little to no formal work experience (only years of unpaid domestic and reproductive labor #WAGESFORHOUSEWORK), is entirely dependent on his husband and community who will reject him, if not subject him to corrective/punitive violence, should he come out, not to mention the economic burden of divorce. and then either have his children taken away from him and told their mother is schizophrenic or possessed by demons, or try to raise his children on his own as a single parent?

its not a shocker that a lot of trans men simply choose not to. or don't figure its a choice at all; how many have been trained from childhood out of expecting autonomy over their life or body in the first place? that you put your husband and children and community and god before yourself and your selfish wants, especially when those wants are perceived as diseased and unnatural?