Along the lines of what has already been said, I think another big difference vs. the eastern world is that even when people in the USA are tolerant that they still have a total lack of understanding of transsexuality.
I hear Native Americans had respect for the concept of two-spirit people and transgendered pepole in general. I think eastern culture has this as well. It just sounds to me like people are more accepting of the fact that different people "find themselves" in many different ways.
In the USA there are plenty people who are tolerant of gays and even transsexuals, and people tend to understand at least a little bit the concept of gayness. But in my experience most people simply don't understand transsexuality. They don't believe in it. If anything, they think it's a mental illness. As nice as people may be, most of them think that inside I'm really just a confused gay man.
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