Fear, confusion, rejection, hostility, being cut off from your family...
I worried about all these things and all I was doing was coming out as gay. And I live in the UK, which has strong legal protection against discrimination on the basis of sexuality and gender, and a relatively accepting culture.
I can only imagine it was a thousand times worse to come out as trans. Or even to understand it in yourself - again, this took me years and I was "merely" discovering that I was gay.