For a person with anxiety coffee can be like jet fuel , consider switching to half caffeine for awhile and taper down the amount you drink by increasing the amount of decaf until it's straight unleaded decaf, this could help your anxiety and possible help for your sleep, drinking caffeine after 12 noon can keep you up . As others have said take advantage ot the time you have with the therapist, and be completely upfront with them that is the only way they can help , bring all your issues to the table lay them out and ask the therapist to help you prioritize the impact each has on your life and happiness ,both current and future , therapists can help you resolve the stumbling blocks , gender dysphoria may be an issue that they can help you decide if it's holding you back from a decent life, therapists can only be as much help as you let them , so don't hold things back, they are not there to judge only observe and help you sort anything holding you back .
When medication is first started many people feel sort of numb, this should change , however keep your prescriber aware of how you feel and any side effects on every visit ,and keep every appointment , an investment know of your time can pay off big later.