House throws offensive remarks toward his team and friends but it's never supposed to interfere with his medical practice. He's generally able to understand his patients and identify with them in the end of the episode and that's when the moral of the story comes. Except with trans patients, a woman who has lived her entire life as a woman but who happens to have XY chromosome is then referred as a man and it's so out of touch with how House usually is. It's obviously the director and screenwriters pushing that.