Let’s roll it back a bit. There’s a bit of a difference between “accepted” and “tolerated”. For the most part, the trans community is merely tolerated by the majority of the country.

What difference does it make that they don’t?

What difference does it make to anyone that people are doing this in their own game? It’s not like this mod takes the option away for everyone. It doesn’t. It only effects their own private game they’re playing in their own home.