A lot of "transmen" are sexually abused women who dealt with what happened to them by rejecting femininity and trying to become strong. Some of them eventually realise that cutting off their tits isn't going to solve their problems and they piece their lives back together. "Transwomen" tend to have a lower recovery rate, at least as far as I've seen. Most of them just sudoku. As for what to do with them? I'm not sure they necessarily belong in mainstream society, but I don't see any harm in rescuing cult victims (which is exactly what they are) and establishing a community for them somewhere.