The next level after ur granny tranny (NOTE: this is not the worst insult yet)
George: Ur granny tranny Bill: Don't make me say it
George: DO IT!
Bill: NEVER!!
George: DO IT U FUCKIN PUSSY!!!1!
Bill: Ur pappy trappy
*Bill gets wiped out from existence, the earth splits in two, a supermassive black hole replaces the sun*