Elizabeth is an Okama from Momoiro Island. He was the one who found and took care of Sanji while he was passed out, but when he regained consciousness he hallucinated that Elizabeth was a young beautiful woman and chased after him. This soon led him to Elizabeth’s frilly home where Elizabeth attempted to convert Sanji into an Okama. After this Sanji recovered from his hallucination and realized that the whole island was filled with Okama and he proceeded to run off. Elizabeth and the other Okamas chased after Sanji and eventually caught up to him.

(Source: One Piece Wikia)