Luigi Mangione, the former Ivy Leaguer accused of assassinating UnitedHealthcare CEO Brian Thompson, lost a fight with a gang of seven “ladyboys” in Thailand months before the crime, according to a new report.

The 27-year-old Mangione is being held without bail in New York City while awaiting trials at the state and federal level in connection with Thompson’s pre-dawn ambush shooting on Dec. 4, 2024, outside a hotel where he was supposed to attend a shareholder conference later that morning.

In the year before the assassination, Mangione traveled to Asia, climbing a mountain in Japan and drinking with expat Americans in Thailand, according to The New York Times.

It was in the latter country where he was reportedly shocked to learn how little an MRI could cost outside the United States — and where he told a friend over WhatsApp he was beaten up by a group of seven “ladyboys,” or transgender women, in Bangkok in March.

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It’s not clear how serious about the brawl he was in the messages. He attached a photo showing scratches on his arm, according to the report. After that, he returned to Japan and took a spiritual mountain climb up a trail where women hikers are not allowed.

From there, he went to India, where he met with a writer who shared an interest in the Unabomber, Ted Kaczynski, according to the Times report.

By December, according to prosecutors, Mangione had allegedly written about his disdain for the American health insurance industry and wanting to “whack” a CEO. He is also accused of wanting “to incite national debates” about its shortcomings.

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Police found spent and unspent bullet casings while investigating the assassination, emblazoned with the words “deny,” “delay” and “depose.” They appear to be a reference to the title of a book that is critical of the U.S. health insurance industry called “Delay, Deny, Defend.”

Thompson, 50, was a married father of two from Minnesota, visiting New York City for a shareholder conference. Surveillance video shows a man approach him from behind and open fire with a handgun, which police allegedly recovered in Mangione’s bag when he was arrested five days later.

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A New York judge found no basis for terror-related charges in the alleged assassination case and threw them out last month — taking the top state charge of first-degree murder and a potential life without parole sentence off the table. Mangione still faces a second-degree murder charge, which carries a maximum penalty of life in prison, with the potential for parole.

Federally, he faces charges including interstate stalking and using a firearm to commit murder, which could carry the death penalty. In Pennsylvania, where police captured him after a five-day manhunt, he faces additional firearms and forgery charges.

Mangione has pleaded not guilty.