I hear you totally on the restroom thing. Going to the restroom in public still makes me nervous, even when I feel confidant about myself and how I'm looking, not least because I use a Service Dog for something unrelated, so it's an absolute *guarantee* that I am going to at least get looked at by every dude in the bathroom, but I've also tried going in the womens rooms, and the glares there are ten times worse. Like, seriously. Honestly, I just turn the tables and if someone is looking too long I come out with a "WHAT?" And then feel like a jerk, because they just want to ask about the dog, and I'm like, "dude, I'm trying to wash my hands/wait for the stall/take a piss, shove off"
Most guys will get the hint, but you have to find it in yourself to be slightly more confident, even if you don't think x,y or z is going for you. I still choose really private restrooms when I can (banks are usually GREAT for that) and as far as my SD, I suck it up, because that's life with an SD.
As far as your looks, honestly, 100% being blunt here, your cheekbones/cheek are a little "off" for some reason to me, I can't say why, maybe too rounded still, just that they look slightly feminine, and your expression in that picture (and the few others that I've seen) is typically a "softer" more feminine look. I have "resting bitch face" lol, so I come off as a complete a*shole without meaning to, so work on your passive face. Pull your brows down slightly, and don't quirk your mouth like that in photos because it accentuates the roundness your cheeks have going on.
I don't remember a full body picture of you, so I'm going off of the one in the thread, but see if you can push your shoulders out and down. From memory you seem to keep them somewhat drawn up, which is a totally understandable habit that I think most of us have developed, myself included, but down/out/back gives a more masculine look.
Until I lost the weight in my hips, I did not wear shorts, no matter how hot it was, because they give you hips. I just found some really lightweight jeans and a couple pairs of cargo shorts with the pockets well below my knee and those helped disguise the hip area. Black sucks, but it's definitely slimming and hides the stupid things on your chest, as well as getting a binder designed for hotter weather. I ordered one from Lesloveboat that's helped a TON, so that I'm not constantly layered up.
Plaid does work for me, as long as I stay out of certain areas of Atlanta lol, and even then I still pass sometimes, especially if I'm with very femme girls or my younger cousins/nephews. Vocal practice can help with your voice if you're willing to put the time into doing that, and I did the first few months I was on T. I got together a bunch of "old" gospel and motown where the singers have deep voices and practiced singing in that range, as deep as I could push my voice without it hurting, and it helped me lower it enough to get into the "andro" range, where I wasn't immediately pegged as female as long as I kept from my original pattern and cadence of speech, which is another huge area that will give you away.
That's actually still my biggest hurdle. I speak like a girl, even though I sound like a guy now. Complete with the inflections in the wrong places, the uplift at the end of sentences, ect. It's hard to break out of those habits, but they're the small subtle ones that get you read incorrectly. I see a LOT of videos of guys 5, 6, 7 or even longer on T that still have a feminine pattern and cadence and only practice and CONSCIOUS thinking about it will break. I still slip, but I'm lucky enough that when I do it gets passed over as me being weird because my voice is now decidedly within normal male range.
As for acne, omg man, do I feel you on that one. I keep waiting for it to clear up and go away, but it's been forever and the only thing helping is actual acne face washes, the strips you can buy at wal mart to help clear pores/tighten them up, and washing my face twice a day plus putting a little bit of lotion on there to keep everything from drying out. That and keeping my oily hands off my stupid face, which is hard because I just want to pick at it. :p
I shave my face, not regularly, but often because like you said, staying clean shaved DOES help keep acne down. It sucks because I feel like I worked HARD TO GROW THOSE dammit, but yeah, clear skin is somewhat more important to me lol. I'm not as old as some guys on here, but I'm old enough that I shouldn't be having acne breakouts and looking like a teenager (plus my mustache is a dirt 'stache really, and I don't need that in my professional life haha)
As far as your pups go, it can take some doing, but there ARE places out there that take in special needs dogs, no matter what their special need is. I know of one in home place here in Atlanta that specializes in dogs that need daily injections, seniors and blind dogs, and then another that specializes in dogs that don't do well around any other dogs ever. So definitely start asking around. Look up trainers on the APDT website, find a CPDT-KA in your area and start calling them and seeing if they know of a boarding facility that can manage your pups for the time you'll be gone having surgery.
Hang in there man!