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1* AlternativeJokeInterpretation: At face value, Brian throwing up and desperately trying to clean himself after learning the truth about Ida seems to be at the revelation that [[UnsettlingGenderReveal he slept with a trans woman]], though this is not explicitly said. Considering his line comparing Ida to a sex offender, his disgust could be more about the fact that the trans woman was [[ArchEnemy Quagmire]]'s father in particular.
2* BrokenAesop: The episode was meant to be a sympathetic portrayal of transgender people yet it never once addresses how society feels about transgender people and how they aren’t something to fear. While Peter's actions could be the case of HanlonsRazor, it's blatantly obvious that Lois is transphobic. Yet the episode never highlights how they're wrong for feeling the way they do about Ida, instead opting to present Quagmire in the wrong for not instantly accepting her feelings about herself.
3* BrokenBase:
4** Did Brian deserve to be beaten up by Quagmire? Yes, it's yet another example of Quagmire's hate for Brian, but Brian didn't know anything about Quagmire's dad getting a sex change and Ida never told him about it. So really, only those who really do hate Brian will see it as something he deserved (although he did pin the tab on Quagmire's dad's room, really was just gonna do a one night stand, and did laugh after learning about Quagmire's dad gender reassignment surgery before it went to horrified {{Squick}} at putting two and two together, but that's still disproportionate).
5** The fact that the episode focuses more on Quagmire than Ida is also a point of contention. Some found it interesting to explore how a family member would feel about a loved one coming out as transgender and learning to come to terms with it. Others feel that doing this meant the episode failed to flesh out Ida's own feelings and conflict, making her decisions come off as [[UnintentionallyUnsympathetic inconsiderate and selfish]] while Quagmire is [[InformedWrongness unnecessarily vilified]] for not blindly going along with what she wants.
6* CrossesTheLineTwice: Brian vomiting for 30 seconds straight after he finds out that he found out that Ida was trans? Pure NauseaFuel. Brian screaming after he's done vomiting? Hilarious.
7* SugarWiki/HeReallyCanAct: [=MacFarlane=] ''really'' does nail Quagmire's wrath and hatred at Brian during his beatdown, and it's terrifying.
8* InformedWrongness: Quagmire is depicted as being inconsiderate of his father's needs, but the episode doesn't elaborate on Ida's experiences with gender identity issues and it portrays Quagmire as being transphobic for not immediately accepting a life-changing revelation about his family. Quagmire is just in shock after discovering Ida's sexuality and isn't getting the right answers from his friends and family. That's a lot for a person to come to terms with all at once. The fact that Peter and ''especially'' Lois are actually transphobic but are never called out on it makes it worse.
9* JerkassWoobie:
10** Sure, Brian can be a jerk at times, but in this episode, it is hard not to feel bad for the canine when Quagmire beats the living crap out of him. There's also how Peter and Lois needlessly belittle and disrespect him whenever he interacts with them in this episode. Ida also didn't tell Brian about her recent surgery, something Brian would have needed to know before they had sex. As he could have damaged the surgical scars or caused other problems during sex, meaning Ida not only lied to him about her transition, her irresponsibility could have caused damage to both of them.
11** Quagmire is presented as the bad guy for not being able to handle Ida's decision when in actuality he's the only relatable character in the entire episode (despite the fact that he's normally ''far'' from relatable). How can you blame him for not accepting this change when everything he's ever known has changed overnight? In fact, the episode just uses his reactions to invoke CringeComedy. The only reason he isn't UnintentionallySympathetic is his NoHoldsBarredBeatdown on Brian for sleeping with his dad.
12* NauseaFuel: Brian throwing up when he finds out that Ida is trans, to the point of forming a huge puke puddle... for a good ''30 seconds''.
13* OvershadowedByControversy: The episode received backlash from several LGBTQ+ organizations and The Parents Television Council. They criticized the episode for mishandling the issue of transgender people with the mishandling shown through Ida’s effeminate behavior before her surgery, Lois throwing the food Ida brought over into the trash, and Brian vomiting for half a minute when he found out that he slept with Ida. Other people had issues with the episode include showing Quagmire getting an erection when he embraces Ida and the brutal assault scene involving Quagmire beating up Brian.
14* SignatureScene: The scene where Brian throws up for 30 seconds is what most people remember about this episode. At least almost as memorable is Quagmire beating the tar out of him shortly thereafter.
15* UncertainAudience: A huge criticism of the episode is that, without prior knowledge of [=McFarlane=]'s stance on trans issues, the episode does not make clear who the target of the jokes are. Is the audience supposed to think Ida is the butt of the jokes or are the Griffins supposed to the antagonists and therefore ''they'' are the butt of the jokes? Trans viewers were put off by the rampant transphobic jokes, while transphobic people or those apathetic to the trans community won't truly sympathize with Ida's struggles. This resulted in the episode's mixed reception.
16* UnintentionallyUnsympathetic: A frequent criticism against the episode is that, despite wanting to be a sympathetic portrayal of transgender people, Ida is not focused on enough for the audience to genuinely root for her. Despite apparently having considered the surgery for years, which is ''informed'' rather than ''shown'', she doesn't think to inform her son about it until only ''days'' before the surgery is to happen, giving him no time to adjust and then scolding him for not taking it well right off the bat. She also doesn't tell Brian about her recent surgery before they sleep together, something Brian would have realistically needed to know due to the possible dangers that it could pose to them both.
17-->'''Brent Hartinger:''' A male character on the show has sex with a transgender character without her revealing her former-gender (extremely unlikely, IMHO, despite the fact that it's one of Hollywood's most popular transgender storylines), and when he finds out, he spews vomit for thirty seconds, then freaks out while another character compares the transgender person to a sex offender? And [=MacFarlane=] thinks the transgender community will be "very, very happy" and that this is the most sympathetic television portrayal of such a character ever? […] Frankly, it's literally ''impossible'' for me to reconcile last night's episode with [=MacFarlane's=] words, unless I come to the conclusion that the man is pretty much a complete idiot.

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