I'm not sure. Couldn't find it on knowyourmeme, either, and they've got a bunch of them. There's a fairly low standard of shitting bricks for these, one pic I saw was just three girls one with her nose photoshopped to be on upside down.
I think it's that the lady in the photo has been flipped vertically, her elbows seem to be resting the wrong way around relative to the beam behind her. Either that or OMG TERROR perhaps the fall of her swimsuit looks a bit like she has a penis or something.
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