The goal was to feminize his features while keeping in line with his aesthetic and preferred maintenance levels.
Bangs. These cover up the forehead lines, receding hairline, brow ridge, and bushy eyebrows. He could also reshape his brows and get Botox and side swept bangs, but that seemed like more maintenance than he'd realistically want.
Lip color. He doesn't seem to like wearing makeup, but he should make an exception for this one thing. Tinted lip balm is cheap, moisturizing, and delicious, and he wouldn't have to worry about getting the application just right (unlike lipstick.) Maybelline Baby Lips in "Cherry Me" is the shade that was attempted here.
Side cut. The side cut has been raised a little higher. This is because his shave currently lands right where a bald man's ring of hair would be, so people see it and think "bald," even though it's technically reverse-bald. The side cut stayed only because he seems intent on keeping it.
Piercings. Males have a longer philtrum than females, so these were an effort to create the illusion of a shorter philtrum. Our brains group the Medusa piercing with the top lip, and likewise the septum ring with the bottom of the nose. This gives the impression that the philtrum is only as long as the distance between the two piercings.
Tattoo. Women who are into alt fashion will often have tattoos in places that accentuate their femininity, so he was given a flirty botanical tattoo for his decollette area. I also thought it might be a good insurance policy to further distract the eye.