It’s a concept album where Marshall is battling with Shady. Theres a lot of fucked up shit, but the idea behind it is that it’s a fucked up character saying it, much like Cartman in South Park (which he directly talks about on the album), but he directly acknowledges that this character/version of him is fucked up.

In this particular case however, he basically just says “I support trans rights, I’m just not sexually attracted to trans women” in a very crass way, as is his style