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the way they can go absolutely paranoid over it is uncalled for, but even for non-transphobes, the concern comes from the fact most really can't find trans women attractive in bed
you get the same with gay men too and female genitalia. It's an unconscious thing that immediately turns them off. For both it's apparently like watching maggots
difference is gay men (are more accepting and) tend to have healthier prospects so it matters less :p