The past lovers are probably alive but suffered badly or something like that. The girl is of a typical case of "intersex" similar to in real life, where she is an actual female, but because of the genetic malformation her **itoris has grown into a sort of essentially non-functional **nis. In their religion/country, she is treated in the same way as half-elves which are seen as "filthy" beings as they are not "of nature's order".

Note that the word they used here can also translate to bisexual, but (in real history) there has been no case of an actual bisexual/intersex person who has both sexes' "complete" organs which would've essentially meant they could self-reproduce alone. The scientific records have always been that there's an actual "original" sex with functioning organs, but there are "extra" bits of the opposite sex that got included via malformation. This character seems to be a girl but since that "part" is visible down there, she gets treated outwardly as a guy by some characters like the blonde waifu.