When I was 12-19 years old I thought this episode was funny. After to coming to terms with being trans at 20 and looking back on this episode I realize that this episode is actually kind of traumatic for me. Growing up as a boy, I always wished I could magically become a girl or that I was just born as a girl in the first place. I didn't however want to transition and become "a freak". The opening scene with the vaginoplasty is absolutely tasteless. Them using footage of a real life vaginoplasty alongside the irreverent dialogue not only disgusted me but made me disgusted with the idea of being transgender. Then on top of that they compare gender transition to being trans racial and being trans species, which instills the idea in the viewer that being trans anything is ridiculous. You could argue "oh it's just an edgy joke" but at some point a joke has gone too far and is spreading genuine hate. Literally the message of this episode is that transgender people are a joke and the idea of being transgender is ridiculous. I lived most of my life as a hateful, bigoted male because I was basically told that if I tried to be my true self I would be a freak and be seen as little more than a joke.