I'll say this about Pixy. I think her meltdowns are partly due to mental illness, but part of it is just her not wanting to accept the responsibilities most other people have to when they grow old. Maybe when she cries about homelessness, it's just her parents telling her to clean her room a bit more sternly because she didn't do it the first time when they asked nicely.
When she says she needs to finish her commissions, it's really her just wanting to be paid for whatever she wants to do. I mean, we all wish we could be paid to just exist or for dabbling in stuff we love, but most of us can't monetize our interests, so we nut up and take the jobs that pay the bills even if some of us don't like it. Even artists who haven't made it on the merits of their skills yet take on non-artistic jobs while they do commissions on the side so they won't be burdens on their loved ones.
I could be wrong, but I think the misgendering at stores is just a cover for Pixy to point at as to why adult jobs aren't for her. I think it has been covered here that she mostly hides in the corner and is pretty much useless in the times that she did hold a job.
As for earlier intervention helping her out, maybe. Other people here are far more capable in making an assessment if it might have helped, but Pixy did (and does) have people willing to carefully step on eggshells and be actual friends with her, only that Pixy's eggshells are more fragile than others, so even one comment that's actually helpful but Pixy dislikes merits vitriol from her, leading to the person stepping away. I have no idea how much of that bitchy personality is due to her mental illness, but it kinda feels to me that's just how she is, even without said illness.
Then there are her parents still willing to shoulder the burden that is their daughter as she approaches 40. And what a burden she is - mentally, emotionally, financially. She's not lacking for support, at least her basic needs are covered as long as mom and dad are still alive.
As far as cows go, Pixy is relatively harmless, so I wish her well, but it's really on her to want to grow up and accept advice from people who care about her. For the most part, she's locked into "me, me, me" mode.
