De roman opent met de zin:
'I was born twice: first, as a baby girl, on a remarkably smogless Detroit day in January of 1960; and then again, as a teenage boy, in an emergency room near Petoskey, Michigan, in August of 1974. Specialized readers may have come across me in Dr. Peter Luce's study, 'Gender Identity in 5-Alpha-Reductase Pseudohermaphrodites,' published in the 'Journal of Pediatric Endocrinology' in 1975. Or maybe you've seen my photograph in chapter sixteen of the now sadly outdated 'Genetics and Heredity'. That's me on page 578, standing naked beside a height chart with a black box covering my eyes.'