This article argues for what the author calls a trans-mad aesthetic of space, defined as designs or artworks that embark, sense, emote, and collect, in ways that queerly disrupt the norms of the public sphere. These four aesthetic operations resist, in turn, four current affective/spatial norms of mental health treatment: confinement, rationality, repression, and an individualizing model of madness. As part of unfolding this model for a trans-mad aesthetic, the article asserts that the link between transgender and madness (as categories) is not merely one of addition—say, people who are both transgender and mad—but, rather, one of mutual constitution. To make these suggestions, the article engages an eccentric archive that includes posters that advocate transgender depathologization, Greek mythologies of gendered madness, government legislation about sexual sterilization, and psych ward design protocols. Its two key case studies, however, are artistic: Hannah Hull and James Leadbitter's “Madlove: A Designer Asylum” and the oeuvre of Montreal performance artist Coral Short.