It could be space aliens, it could be anything. Racism and homophobia are socially sanctioned in some families and communities and that's what the paranoia latches onto. Look at Bobby Fischer. World champion chess player, but anti-semitic lunatic.
I grew up in an environment where people of other races, religions, homosexuals, sexually indeterminate people, even extremely eccentric people who smelled funny were all unconditionally accepted. My grandma could top anyone on crazy and my parents let her live with us. They didn't even require she bathe more than a couple of times a year.
So there's a stranger in the kitchen frying bacon in the middle of the night, he looks sort of like Elton John, especially the outlandish glasses and shoes, and he's not wearing pants. Well, okay. The half-dozen family dogs seem all right with him so he's probably not dangerous. Go back to bed.
The targets of paranoia in my own untreated state are a little less common. Doctors and needles are one, and getting my hair cut is another. In my screaming worst paranoid OCD state I have to keep the invisible umbilical cord that attaches me to this world untangled. For every clockwise rotation there has to be a counter-clockwise rotation. If the count gets too unbalanced I get extremely anxious. It's an OCD counting disorder, I count the twists. If I'm too long on the merry-go-round it becomes really obvious that I'm untwisting myself afterwards, and Hunter's reputation as a very weird kid increases.