Personally, I've never had any issues using my DL when asked for identification as to age or confirmation of my credit card, which I genually appreciate. If they look at me with a questionable look, I respond that my pic was taken on a "bad hair day". That has always worked fine.
I've been told that in Texas you can get a state Id card that is separate from your DL, and that some persons have been able to get those while in fem. My reservation is that as typical with all government departments, I'm sure at some point in the future, the state would get the ID card picture on my DL reissue?