Note first off that balding doesn't necessarily make you ugly, but it's almost a universal rule that being able to grow hair on your temples makes you more attractive than not being able to do that.
It's hell on earth because it's like you're constantly being gaslit by the people you trust and value most in life. It would put me at peace of mind, personally, if someone that I cared about and who cared about me would just come out and say "yeah, you're not particularly attractive". It makes me feel like a loon because every experience I've ever had in real life with women has been overwhelmingly negative, and things that other men do are viewed as positive when they do them but when I do the same thing it's ignored or repulses women. To have that experience of knowing something is different about you compared to other men is heartbreaking in itself, but to then be told by your parents or family members that you're actually good looking creates two problems, first it makes you question your own sanity, second it makes you start questioning your behavior as well as your looks (what if they are right, maybe it's just my personality/the way I act around others?).
I personally had tons of friends in school, the guys liked me, thought I was funny, always wanted to be around me. They used to tell me I should do stand up comedy, whenever a guy in the group was feeling sad or looked down people would come to me to cheer them up because they said I could make anyone laugh. The purpose here isn't to brag, it's to simply point out that people who are properly socialized are capable of making accurate self evaluations. I can, however, tell you I'm not good looking. I'm just not, I've seen myself in videos, I've seen pictures of myself next to other people, I see myself in the mirror in the gym standing next to other men (who actually get attention from females) and I don't look like them, I don't look attractive and I quite literally don't attract women, I'm not attractive. This self evaluation doesn't come from some mental pathology, it comes from the life I've lived and the results I've gotten. The men who get attention don't have particularly high social status or something, they're just normal young guys like me, but they're good looking. It's that simple.
To be told that it's not your looks (or if it is your looks, it's always something you can change like your haircut or your t shirt), but that it's personality/temperament is really messing with me, especially to hear that from people I care about. And it's not that they directly say "it's your personality", rather they say that women don't particularly care about looks, they care about "confidence" or "being funny". That implies I'm not either of those things. Well I am a funny person, people have told me that my entire life, I have no reason to doubt unsolicited compliments from others (especially when it's always the same compliment and I'm not sad or looking down when they say it). But nobody has ever called me cute or hot, so what reason would I have to believe I am? Why should I change my personality, my demeanor, who I fundamentally am when others have liked that about me? I don't want to be some caricature of a confident man, I just want to be me, and others like me when I'm me. Women, however, don't like what I look like, and no amount of lying will change that fact.
