I started out right from the beginning with an alias, a picture you can't easily search, and a VPN. I never say where I live and I let on-line friends into my real life very slowly and carefully. It's a shame to feel like you have to do that, but more than once, I've been very glad that I did.
Online abuse really is out of control. Medium used to kick people off for harassment and otherwise violating their rules. I got one guy booted for mocking the seriousness of rape, but it sounds like those days are no more. It's a shame they don't do more to protect content creators. It definitely does take a toll on one's emotional and mental health.