what does seem to work well is focusing the camera towards the point where I'll be setting it down, keeping it on manual
@f0x I'd happily take some pics of you when an opportunity occurs. :)
Other than that, using a tripod, self-timer and manual focus is probably the best solution. You probably know that already, but using short focal lenghts for portraits is never a good idea because it distorts the proportions of the face. (Which, at least for me, also increases dysphoria.) A really good portrait at arms length seems rather impossible to me.
but framing is so difficult