This Bildungsroman does the latter. Alex is a self-confessed loner who has grown up ashamed and desperate (‘there is something really wrong with me’). She is in the midst of common adolescent upheavals: sexual awakening, transferring to a new school, wanting to be accepted by others, searching for an adult identity that fits. These are traditional themes for Young Adult fiction, but Brugman’s story has a twist.

Alex is a girl trapped inside a boy’s body. Through her voice we are offered insight into the vividly imagined world of an intersex teen. Her narrative is juxtaposed with posts from her mother’s blog, which express horror at Alex’s transgender identity and seeks advice from an Internet community that is sometimes less supportive than she hopes. Through Alex’s experiences, too, online ‘trolling’ and cyber-bullying are contemporary themes the book touches on.

Distressing and graphic imagery is frequent. Alex’s unstable mother in a rage, her face filling ‘with blood under the skin like a big red balloon which will finally explode and splatter the walls’, is followed by a scene in which she beats Alex with a telephone, calling her a ‘freak’ and ‘pervert’. At times, this marriage of violence, mental illness, and abuse with the already complex theme of intersexuality becomes relentless. These are fascinating topics for a teen novel, but, despite Alex’s eventual positive affirmation that ‘you can’t change other people, you can only change you’, her world is not always a pleasant place for the reader to dwell.