LOL!
Like I keep saying (and saying) this sort of ignorance seems mostly found in the USA with conservative, white evangelical Christians.
Urban Americans, especially Democrats, are more likely to accept transgender people.
The Europeans I've met here in Thailand, and the Thai, seem blase and indifferent to transgender people. Since Thai people self-identify gender as they speak, we don't have to guess.
Although everyone seems cool with it here, Thai elementary kids tease each other the same way American kids do.
For instance, the other day, a 4rth grade boy did something silly and one of friends casually called him a "kathoey" (she-male).
But nobody seemed to care or notice.