The trans-female was put on puberty blockers, so there wasn't enough cock skin to make a vagina, so they had to use the colon.
"She" died less than 24 hours after the surgery due to complications (necrotizing fasciitis due to E-Coli infection from her own bowel) from the surgery.
Apparently, trans-women have less mental issues when they take puberty blockers, but then have to use the riskiest type of surgery to give them vaginas.