Do you have a hard time separating reality and internal fantasy?

I know I do, to the extent I don't bother much to anymore. Conversations I imagine having in my head, I initiate in real life, by the time I was 19 I had my gender change, if I don't like the place I live in I move, if I don't like the people I hang around I leave, don't like my hair I change it, don't like my voice I change it, don't like my body I eat less and work out. If I don't like the way something in my life is I work to change it, I don't wait for my fantasies to come to me. I just don't see many people adopting this mindset anymore, everyone just seems slaves to their lives. I'm not saying following your dreams is easy, just nobody seems willing to set aside what other people expect from them anymore, everyone wants to play it safe in their life.