It is interesting to observe how folks will use shame and then mask their discomfort with dark humor. The natural part of humanity and it's tribal underpinnings, is to pull away when threatened.
Only when safe does one have the confidence to step up and engage with other humans.
If folks decide this is there way, it says more about the society and environment then it does about the person.
If you watch the video, what was interesting was the anime that helped make him feel happy was showing gratitude for him doing things.
His needs are simple, and yet they are not being met because of others expectations. Japan is a harbinger for what is coming in America, just 10-15 years ahead.
So if a person goes ugh or sweet baby jesus, look in the mirror on why a person is so judgemental in taking joy from another human being.
As for the societal implications, his/her/their body ... their choice and their right. If society collapses or has issues, then that society needs to figure out how it failed the person and not how the person failed the society.