Since coming out as transgender in 2015, Lillian Maisfehlt has spent $10,000 on electrolysis and had voice and hormone therapy and breast construction. She also spent 10 days in Pennsylvania recovering from vaginoplasty, an operation that few surgeons perform for transgender women in Connecticut. Maisfehlt, 47, of Chester, said the pain, cost and occasional fights with her insurance company for reimbursement have been worth it. “Each step has made me feel a little bit more like myself,’’ Maisfehlt, a librarian at Gateway Community College in New Haven, said. “I’m Lillian.