This may not make sense to everyone but the way I deal with the downstairs growth aspect and the permanent changes there is this.
I can't stand that area. I hate seeing it visually, I don't like touching it except to wash, if I never see it again in my life I wouldn't care. Growth occurring down there and changing it's appearance doesn't matter. Because that area already looks like the mouth of hell to my mind and I'm not going to spend much time on it or with it, if you get what I mean. It's true I'm not really interested in relationships any more so I won't have to face needing to utilize that part other than having to take a leak. But to me that part was a disaster area for me anyway, it growing some and changing isn't going to make it any worse since I'm already about as dissociated from it as a human could be while still having it attached.
The other changes - I'm looking forward to my voice changes. I think it's taking place already, I sense a background deepness in it and an odd sensation in the throat. If I need to disguise the changes for now for any reason I still can.
The facial hair, I'm not bothered either way really. I shave my face anyway and have for ages to get rid of the vellus hair. I'll probably spend some time shaving it while it comes in.
Any muscular changes and fat distribution changes are more than welcome. Moon face isn't but I don't have that at this point.
These permanent changes really don't bother me. People think I'm weird anyway. It's not like I'm losing some beloved status or anything. They thought I was odd before, and they'll probably think I'm odd after. Or maybe not - maybe I'll actually fit in more. But it generally can't be worse than it is currently for not fitting in.
What I'm not hot about is potential discrimination, nasty comments or whatever. I live in a village in the middle of nowhere and people here are kind of like a clique with each other. I'm an outsider anyway, I'm not a local, though I've been here for 7 yrs. I don't know many people as they're not like this gregarious community. But in general I've not had any nasty comments for standing out a bit... I guess we'll find out how they feel about it. There is a trans person in the village who is - well, eccentric I suppose. But people use their chosen pronouns and stuff and seem ok with them. So maybe it'll be ok with me too. My SO seems to think we'll have to flee the area or something which I think is being over-dramatic. I'll flee the area if people come to my door with torches and pitchforks, but beyond that I don't think there'll be a huge problem. I might have to explain myself to some people if they ask but... well, I think I've made a good impression so far. If that doesn't convince them I'm a nice person regardless of what I'm doing with my body, what would.
I did get the T and waited a few days to think of the implications (despite having thought about them for 3 yrs already, I had to do it again) before using it, but the way I see it, I don't have all that much to lose. I won't miss my old body, I'm feeling much more calm and untroubled mentally since starting T, and it's actually given me some energy.
In a way I feel like the T is necessary medication for more reasons besides just its virilising effects. I was shown to be deficient in my blood work of any of the sex hormones, which was putting me in poor health so I basically needed some kind of supplement anyway, whether T or E, and I'd rather it was T. It's making me feel far less worried about everything in my life which is EXTREMELY welcome, because I was being driven up the wall before with either too much or too little E. And oddly, I walked about the apartment yesterday after a shower and actually forgot about topless dysphoria for a moment. Or it was just gone or something. I felt more natural for a short time.
I don't know how you feel but my life as a woman is lousy, I make a lousy woman because I'm just not one I guess, and the rest of my life is likely to be equally lousy unless I do something to change it. So while the changes are "significant" or even "scary", it's worth it to feel less of the constant awful dissociation and stress.