I'm a trans woman (MTF) started HRT on March 6 2018 and I'm 38. What FFS do I need to look feminine? (photos)

I think there are a few areas that you can focus on based on these photos. Forehead reduction and contouring and brow lift can really feminize the upper part of the face. For the midface, I would consider cheek augmentation and rhinoplasty with a lip lift and conservative lip augmentation. Your jaw is quite strong and jaw contouring can make a big difference for the lower face. The hormones should help the skin and hair so that will benefit you as well. Consult an FFS surgeon when you feel you are ready. Best wishes.

Hello Shyla38! Thank you for your photos and question. Based on your photos, it looks like you already have good skin texture and tone with very few fine lines. If you haven't already started, but sure to begin the process of facial hair removal which makes a huge difference. As far as surgery goes, I would recommend setting back the brow bone, lowering and rounding off the hairline, and raising the eyebrows. I considering these three procedures as one and call it the forehead package. Research shows that this procedure makes the biggest impact in determining gender, and it is what I notice first on your face in particular. Other things you may want to consider are a rhinoplasty to make the nose smaller, a lip lift with augmentation to shorten and fill in the lips, and chin and jaw reduction. You have great cheekbones, and I don't see much in the way of an Adam's Apple. 
With this combination of procedures, you will want to plan to take at least 2 weeks off of work at a minimum. Most take 1 month off to fully recover. The nose and jaw take the longest to heal because of swelling. 
Best of luck to you in your journey!
Sarah Saxon, MD