Downstairs for me, but both are horrible. I think the chest impedes my ability to interact with people, move, and simply exist comfortably, but the downstairs stuff will always impede my relationships, my sex life, my... everything. That is to say, I don't have relationships; I don't have a sex life. The chest can be taken care of, probably will be next year; I'll be damned lucky if I ever get anything close to a real, normal-sized fully functioning penis, which is exactly what I want. I'm not about to give up, though. But all in all, the bottom dysphoria is going to be with me for a lot longer than the chest stuff, and I think it psychologically affects me on a much deeper level.