>Now that I'm getting older, my face is starting to sag.

Have you ever tried Facercise? There's an inexpensive book you can get, or your library might have it. It does great things to your face, improving circulation and lifting things all over the place. I'm over 50 and I get compliments. I think it's because of this, and because of swimming, also. Even I notice my face after swimming. Again, I get compliments. Never worn makeup, and never been called beautiful except by my crazy husband. Seriously, he has visual perception problems. Not kidding. Anyway, facercise feels good and seems to really improve facial structure. I have an MD in my family. She looked at the book and said the physiology of it is valid. She tried it to, and looked better for it, but didn't keep it up.

I sympathize with feeling ugly or masculine. What you've experienced sounds very painful.