I don't think he looks so masculine that I would notice that he's a man if I wasn't looking for it, but he does have certain traits that are definitely male. His chin is large, but probably within a couple deviations of a Scandinavian woman. His hairline is high, but again, within in a couple standard deviations of a Scandinavian woman. What really stands out to me is the length of his nose.
Also, from the SRS thread I saw this and I'm kind of amazed it hasn't been posted here. Apparently some plastic surgeon in KY has been intentionally mutilating trannies.
I'm not prone to sympathizing with trannies (at least not anymore), but that's totally fucked. The fact that she moved from Chicago to Louisville for the surgery makes me think that either she no longer had anything for her in Chicago or that he made completely unrealistic promises about what he could deliver.