There are ways to have some of those perks permanently, typically through ascension (new game+).
It has actually been a while since I played the game and there have been several updates since then. But I believe everything in the mutations database were perks at one point and may still count towards that total (135 total available. More slots can be unlocked through ascension) . Internal mutation score was built up by taking these perks. Also it is possible to reduce/beat the damage taken per turn by having high enough regeneration. I remember that the difficulty settings and easy mode had an effect on the damage but I don't know if they still do.
I have started playing again and a lot has been changed. There used to be an option to gain stat points every time you slept for example and you could turn off spell cooldown in exchange for cheaper and weaker spells. I'm going to play around with races as this is something that is important for my old build to know as it may no longer be viable.
I see thanks for taking the time to answer, if it is locked behind new game plus I won't be getting them oh well.
This is the first time I played this mod and have not played og Coc for a long ass time so this was fun the game is now enjoyable as an rpg with all the customization avalible now and not just a porn game, messing with different race parts and seeing your sprite change is really cool I have no idea why that option is off by default it adds a lot to the experience in my opinion.
As a side note if you want to play a caster I would recommend testing the gazer race I went for you get this perk
Omnicaster: Your magic power is as manyfold as the number of your eyes. Deal less individual damage but cast multiple spells at the same time.
it double casts your spells times the nuber of eye stalks you get and you can have 10.. plus you look pretty baller i think

