Whilst the law has changed, the practical elements haven't changed that much.
It is still a very difficult conversation to have with families and loved ones and many/most still react very emotionally to what is being asked/proposed.
There are still many people who refuse to have the conversation, give consent or for whom their religious or cultural beliefs mean that this is not possible.
We are a very long way from everyone being absolutely on board with organ donation. Blood donation even (very clearly demonstrated by supply issues).
The opt out law just enables conversations to start from that point of view, "your relative had not opted out, had they ever discussed their thoughts on donation?" It does not in anyway mean that organ donation is a given at all.
For those who feel all organs are equal, or that issues around genitalia are just because this is new, I would say read more about the complex psychological issues recipients have with other organs too. Also, would you always have zero concerns - face transplants? Hand transplants? Nothing makes you pause?
It does not actually help the organ donation cause to insist that there are no reasons to feel reticent or conflicted, or to make out that anyone who voices unease is just a stick in the mud.
Luckily, on the ground the hcps working in these scenarios have a greater understanding of the complexities and appreciate that for families to even discuss the possibility is a great act of generosity and bravery and not to be taken as a given at all.