Would you want your wife or daughter to have to share a restroom with him?
It wouldn't bother me in the slightest. Why? The 'guy' thinks he's a girl. S/he's not attracted to females, because s/he thinks s/he's one of them.
I'd be a whole lot more concerned about 'him' being alone with one of my boys (although, knowing my boys, he'd probably get punched if he tried anything funny).