'Invisable Monsters' by Chuck Palahniuk: Did Shane (or Brandy) die?

at the end of Chuck Palahniuks 'Invisable Monsters', Shannon (or someone, its been a while since i've read it) said Shane (or Brandy) was 'gone'. did they say this because he was now a 'woman' again (because they Rea sisters were at the time putting all the make-up back on him), or because he died (because he WAS in the hospital). it said that it was only a flesh wound, but still, what exactly didthat mean?