The handedness of the picture can probably be inferred from the buttons on the women's jackets. Looking at it, I think the picture has not been flipped, but I could be wrong.
Also, notice the absence of a wedding band on Madam Skreecher's raised hand. A Google image search reveals that Ms. Pelosi has been wearing a wedding band - as tradition dictates, on the ring-finger of her left hand for years - so why should she suddenly appear without it?
The whole scene looks like BLASPHEMY to me! And the left hand on the Koran thing... That's pretty questionable too.