it is the case where pixiv tag doesn't really help.

As in, there are tags that may contradict with each other:
>男体化 = Transformed into male(manified? lol)
>ふたなり = Futanari
>ショタ = boy
>男の娘 = trap, a.k.a. otoko no ko
>東方ショタ化 = boyified(?)

Well, most tags are pointing to the fact that this Suwako is actually genderswapped, instead of being a girl with a dick, yet the tag "futanari" means basically "a girl with a dick and a pussy".

And seeing how d@i tends to draw genderswapped touhou characters, I have reason to believe that this is not futanari.(Well, no pussy is shown also, though it is impossible to see even if there is pussy in this case.)

Only tags with * were added by the artist, in this case: 男体化