There is indeed a difference b/w cross dressing fetishism and desire to be of the opposite gender.
The latter, is something that many individuals experience early in their life (they feel in the wrong body). The former is more of a preference and, cross dressing individuals can be heterosexual.
You're asking what to do. That would depend on what you feel comfortable with. Gender change is quite a serious endeavor and you would want to work w/ a professional therapist for at least 6 months. But, there are other options such as- attending support groups of both cross dressing individuals as well as transgendered individuals. That may get you the feel of what category/situation you feel more at ease with (your true self) UK Trans Groups/Organisations
Man can have feminine qualities. Both genders have a part of the other's expressed in the Anima/Animus concept. There may be ways that you'd still be able to express these from within in areas such as your work or at least volunteering (initially). Some individuals become make up artists or pursue other artistic or nurturing positions.
Things to consider would be-
1) am I comfortable enough to share these feelings w. my family, friends and co-workers
2) would a gender change cause me to: ***** ***** friends, partners, etc.
3) Am I financially able to pursue a sex change operation, hormonal treatment and psychological care?
4) Can I find a "happy" medium and be able to express my desires, interests and qualities w/o drastic changes?
5) What sexual partners am I attracted to now? Would that change?