I would say it was a guy and probably still is. When woman becomes a man, their genitalia are surgically created by bringing out their sex organs from inside their body. The penis has to be be surgically constructed from surrounding tissue . The penis in the photo appears to be a real one.
The boobs are surgical implants. They are made by placing balloon like pouches under the skin and gradually inflating them with saline. the skin stretches and once there is enough room, they are replaced with saline implants. This guy clearly went overboard. His implants don't look all that natural. He was probably planing to have surgery to convert his penis into a vagina. It would be an extremely expensive procedure.
I imagine he was killed when he came on to a guy who was later surprised by the knotty bits.