As obnoxious as he's been ever since coming out, I can't help but laugh at how he thinks he actually looks attractive and not psychotic. He only felt comfortable enough to do so after yet another round of plastic surgery (thanks to Frank's bank account, of course), yet he still looks like a man, only an increasingly deranged one. He's desperately trying to fix something that absolutely refuses to be altered how he wants, and the result is an increasingly uncanny visage.
Note how he's still using every trick in the book to make it seem like he's now the dainty beautiful woman he always claimed to be: tilting his head low to hide his manjaw, washed out lighting to hide wrinkles, filters out the wazoo to remove the more obvious masculine signs. But like that last image of John's gormless soyfacing shows, it's all still there. Plastic surgeons have to work with what they're given, and when the starting point is a gangling malformed retard, not even the best could actually make him look remotely passable.
If John were truly comfortable with how he looks, he wouldn't feel the need to continue hiding it. This is a man who is going through the troon version of a midlife crisis, and it's only because of Frank that he's able to attempt to remedy it...and still doing a bad job of it. I look forward to further "no true Scotsman" arguments and failed vanity shots in the months and years to come.