He's reliving his most lifelong trauma from the scar and probably has a lot of self esteem issues from it. Even though he loves her it wouldn't surprise me if he thinks he isn't good enough for her. It's so SAD!!!
He might have been crying since his mom dressed him up as a girl. Maybe she did that to protect him since when he stopped showing up at the lake must have been after he had the hydrochloric acid splashed on him. Also he could have dressed up as a girl so he could go outside unnoticed with the...