In my experience, they show no concern at all. This is Japan, and they are doing a job! I have used these services for many years, and always had good service. Not many biys speak English, but, as you will have seen, you order the services you want from a 'shopping list', ant the items are usually faithfully delivered. If you go to a bar, King of College, for example, the manager usually speaks some English, and has a menu you can peruse! More top boys than bottom, usually, they say Western cocks are sometimes too big!