At some point in the late 1990s....before I retired, the topic of mental illness popped up. We had some guy in the organization either was faking mental issues, or was fully blown walking around with mental illnesses. In the vault, we got into this discussion.
I was nearing age 40, and over a 22-year period....I'd observed probably a dozen folks who had issues, or worked with folks who were in the middle of 'chaos'.
One of my co-workers had been forced into instructor-status, and had some young female airman who had a imaginary 'friend'....to the point that she talked to 'Jessica' (the invisible friend). She'd made it through basic training and around six weeks of technical training....when the friendship came to be known. For some reason, the Air Force couldn't deal with Airman 'Jessica' (the invisible airman). Took the mental health folks about a week to validate the situation and ease both the real person and the invisible gal out.
I had another co-worker who had a young airman arrive at the base (in Germany) and over a 6-month period....the kid got heavily into BDSM (to the point that he was very open and wanted to profess his 'religion'). I asked how he got so deep into this kinky stuff, and the response was some relationship-deal (Air Force female dental hygienist). His boss spent several months trying to get him to some neutral point (just don't make it so obvious)....with that failing. Commander came up....requested a mental fitness exam....the guy failed....a week later, he was 'out'. Oddly, the female dental hygienist wasn't kicked out or treated to a mental fitness exam. Yeah, it's possible that she lasted 20 years.
The problem is....most folks (probably in the 60-percent range)....don't want to hang around, or put 'trust' into folks they consider mentally ill or unstable. I also would agree...maybe two folks out of ten....like to view stuff like this as a theater-situation and allow it to go to the maximum crazy-level.
Asking people to accept mentally ill folks? If you were just asking a gal/guy to accept working around someone who says they are 100-percent Cherokee-Mexican....but are plain regular white dude....I think most folks would go and sign off...without any mental therapy forced upon them.
Maybe it'd be the same with some female who only wants to wear male-like clothing and 'pretend' she's mostly a guy....without any surgical stuff or forced pronoun mandating.
But eventually.....you reach a point where you don't want to participate in 'theater-operations' and keep reminding yourself of something that seems crazy.