It may be. I am not saying the possibility can be ruled out, only that we don't know at present. The WHO doesn't explicitly state that it's sexually transmitted

It may be. I am not saying the possibility can be ruled out, only that we don't know at present. The WHO doesn't explicitly state that it's sexually transmitted because they don't know that it is, and neither does anyone else. For example, the 'atypicality' of the presentation could simply be a consequence of MSM who are used to getting sexual health checkups being more comfortable with showing their genital sores to a doctor or nurse than other population groups. I'm not sure if the presence of genital lesions is necessarily even a good indicator that transmission was via sex. See e.g. https://academic.oup.com/ofid/article/4/4/ofx168/4588539 https://academic.oup.com/ofid/article/4/4/ofx168/4588539