It was quite common for nineteenth and early twentieth century Scottish "wannabe Lassieboys" ... as they were then called, in the Scots high country ... to go to distant Siam for their change of sex operations. This would explain much of the secrecy surrounding the goings on in Kinloch Castle. This, too, would explain the Bullough family's unusual interest in the Far East. However, the master of the castle's obsession with photographs of oriental torture and human beheading probably falls into a different sick chamber.
Today's Bangkok ladyboys, as you can see, have carried the art of sex change to new cosmetic highs. We don't have any pictures (before or after) of the Bullough 'woman' ... but ... well, she did live in a pretty secluded spot. And, that strange shower does hint that something might have gone wrong with the operation.