Fat Paul is a transsexual male. Huge numbers of transexual males will have significant sissy/hypno/subjugation fetishes (almost a 1:1 ratio it seems sometimes) where they want to be dominated and humiliated and forced to crossdress; preferably by a woman (so lol at her pretending to be a man).
That's kind of the misogynistic secret at the heart of transexualdom, that they get off to the humiliation of dressing as a woman or acting as a woman (in their mind).
I kind of suspect people insulting him doesn't get him off because those insults are concomitant with the self-evident fact he's not a woman, thereby ruining the illusion the whole coom is built upon.
I can't find it now, but I remember a survey around six years ago that had focused on transgender people and and various kinks and preferences. I can't remember the exact numbers so these are all rounded to what stuck in memory. Don't take this as absolute or anything.
For FtM the only numbers I remember, and it stuck out due to being so large, it was apparently 80% of them preferred anal, and 60% preferred giving blowjobs, while 30% preferred eating pussy (I seem to remember the study also pointing out the majority of the FtM they studied preferred men). Everything else was pretty close to cis trends. Receiving any form of vaginal sex was down in the single digits. This likely shows that actual gender dysphoria is likely quite common among FtM.
For MtF, oh boy. Humiliation fetish was 70%, being tied in bondage was 60%, CBT was merely 20% (fun thing, I remember seeing that CBT kinks are extremely common among men with gender dysphoria, so this inconsistency might say something), receiving anal was 30%, receiving blowjobs was 90%, giving blowjobs was 10%, giving anal was 90%, eating pussy was 60%, vaginal sex was 70%, sexually dominating another was 20%, and being sexually dominated "in general" was just above 50%, while sexually dominated by a man was 70% and a woman was 80%. The question for that last bit was a weirdly worded IIRC, as it basically was "Do you prefer to be sexually dominated?" with the answers of "Yes", "No," "Yes, but by men", and "Yes, but by women".
There were more questions, but they didn't stick to memory, thinking any harder on it I just remember that the ice cream I was eating while reading over piles of different statistics that day was a bit off. Oh, also that around 6 years ago tiger infant mortality rates were down. There's a happy thought.
The survey was pretty lefty, and I remember finding it suspect, as it had questions related to specific forms of humiliation (sissification, hypno, forced crossdressing, and the like), but they didn't release the numbers for those, they just folded them all together with just plain ol' generic "humiliation". So they definitely saw something problematic in their survey results and knew to hide it.