My history with Anxiety and panic attacks

I had my first panic attack in 1986. that lead to two years of agoraphobia and fear of having another panic attack in public and passing out. Fear of losing my breathing, fear of dying, etc. CBT therapy was being introduced around that time for anxiety and panic attacks. I got a good doctor who helped me back on my feet and out in public. Then a good friend from school came, helped me get rid of my panic attacks immediately, faster than anything else ever could. I couldn't let that go. I needed her and told her I was falling in love with her. I have spend most of my life with her since. Married in 2000. Had a not had the panic attacks would I have asked to get together with her? Probably not- though would have remained in close contact.
I didn't have any panic attacks again until around 2003 when I thought I was having a heart attack and went to the ER and again doctor said that it is probably just a panic attack.
I haven't had a panic attack since but my anxiety found a new way to speak to me and manifest itself in the form of insomnia. Yes, Insomnia became my new kind of panic attack. I had to get treatment for that. I also had issues with sex addiction (masturbation) which grew out of a need to relax myself from my anxiety.
All the counseling made me come out about another fear, that being gender dysphoria. I am one of those closet people (technically still am). My wife knows, she doesn't accept it and I keep in denial of it.
Having gender dysphoria and the fear of, paranoia of going out is a fear I can not even begin to explain. Way out there, over-the-top paranoia. But because of the pandemic and having to move to Oregon to take care of my elderly mom I developed to much urge and desire to get out in public, leading to starting to therapy, which lead to being recommended for hormones. Already been on and off them for short periods in the past, back on them a month and weening off them again. I am hopeful this is the final time and doing it safely but get lots of fears and paranoia about it so making sure I do it safely and don't allow myself another panic attack and pass out and the consequences from that. A therapist once told me I have self-fulfilling prophecies. Yes, I do have that's for sure. I have not only the fear, paranoia and anxiety of being discovered by loved ones about my condition but the usual fears of death, what does God think of this, etc.? yeah, as I write this is one of those situations of "when in doubt leave it out." (the hormone therapy that is).