Pitous gender is unconfirmed; the japanese dont have a word for him/her, they use "that person" with an inflection. In Pitous case, they use "that boyish person". It could mean boy or tomboy, both could apply.
Gonna see if I can get Saha to translate this, because I've been searching for this doujin a while
This is equal parts creepy and hot. THE real disturbing aspect comes in when you start to realize that Kaito is basically just a corpse now. And here he is screwing Pitou. It really does make everything you see here a bit...squicky. Yeah the artwork is awesome, and it's always nice to see Fem-Pitou....but the fact remains, she's basically fucking a CORPSE.