@Marduk , I am basically anti-psychiatry but acknowledge it’s probably better than nothing in our deranged modern society. Strictly I would say people who don’t fit in deserve society to have rules for them to live as part of society, but those rules don’t necessarily provide them payouts or special privileges.
Essentially, if someone is, to me, spiritually called to walk this road, the path should be provided, but we’re not necessarily under an obligation to make it easy. Premodern societies usually had traditional roles for transsexuals, like Hijra and Kathoey.
Some traditional societies do, some don't, and it also varied with given case.
For an interesting comparison, take the theory that in Norse society (and many other, particularly more warlike cultures, had similar ideas) the concept of "berserker" was used as a path for people with certain mental or psychological disorders that create a tendency towards extreme and poorly controlled violence.
Beserkers is a culture-bound condition historically affecting Norsemen. The condition manifested itself among males only as an intense fury and rage (berserkergang, i.e., “going beserk”) and mostly occurred in battle situations. But what more do we know about it from a psychological perspective?
www.psychologytoday.com
A different, probably no less common problem, yet with completely different challenges and considerations.
A society has an obligation to develop exceptions to its rules for those who don’t fit in, but those exceptions have the right to create pressure to behave according to the default. That is the “standard” among traditional societies, and it worked.
The problem is that at the scale of a whole society, those exceptions take resources that could be spent on something else (possibly something laudable, or in harsher times, something necessary), and each such exception adds up with its costs, so it's hardly an unlimited, easy or feasible to apply universally solution.
I am absolutely opposed to clinicalising this or any other behavioural issue. Even Foucault could recognise where that went as an evil. Treating human minds as a potential pathology is a vile development of modern liberalism and it has and is being used to torture opponents to left-wing regimes. Today transsexualism is a mental illness, tomorrow conservativism is.
Just because a tool can be abused doesn't mean that it shouldn't exist at all. Some mental illnesses are mere inconveniences, others have profound and unavoidable effect on the patient's ability to live a normal life at all, transgenderism being somewhere in the middle of that spectrum, making such treatment at least remotely feasible, but on the other hand,
only remotely so. However, how does one apply such attitude towards, say, Down syndrome, or paranoid schizophrenia?
They are already talking about conservativism being a mental illness, with increasing seriousness.
In many communist countries, opposition to the regime was in fact used as an excuse to send people to mental asylums. But that doesn't change the fact that it was merely an abuse of that system, much like "ordinary" prisons, law enforcement and justice system were also abused in these same countries, for exactly the same purpose. However, that is not a reasonable argument against the very existence of a justice system and law enforcement.