Oh my god I am so sorry for them and you Look I know one person who had been like this for a long time after she became a foster child She goes through a lot of the things you mentioned and had in truth run from home and attempted suicide after finding that her foster mother was starting to doubt that she could carry on caring for her I'm no expert don't get me wrong but no matter what happens you can not let them believe they are being rejected, or they will cling to it The Japanese obsession may be a wish to be away from people she knows and the pan gender could be that she no longer wants to be herself I hope what I'm saying helps but I hope things do improve :( Oh and a possible solution would be to try and allow her the same freedoms that she received from her mother, but a massive change over from losing a close friend and relative to moving on is a huge task and there must be patience, and if anything doesn't work do not try and persist, it could make things worse I'm only fifteen so I don't know much, but I if worry for you and hope everything is eventually resolved