Bleccch. The point of this book seems to be to take an Issue and to -- what? I don't know. There is absolutely no depth to this thing. The characters were all the same -- they even spoke the same (I can't count how many times each character began a sentence with "and so...") -- cardboard cutouts, but made from a big corrugated box that you can't break down when trying to recycle it, because somehow besides being bland, they're all really irritating. There's a part of the book where Dana, after her operation (she's now a woman) confesses to the male sin of not being there for Allison, not noticing when and how many times she's cried. Well, Allison, who is an incredibly annoying person, self-obsessed (because her internal struggles are not displayed well at all and instead of feeling emptahy for her I felt disgust), cried mostly when she was not around Dana. If she cried at other times, I don't remember them. That was one of many irritants in the book -- it just didn't make sense.
The whole novel feels like you come in during the middle of the story. Perhaps if we had more history on these characters they wouldn't feel so one-dimensional, personified lists of qualities, mostly, to my mind, negative. I could go on and on and mainly say the same thing. Transgenderism is an issue that definitely needs more exploration in mainstream society, but not done in this way, not with shallow people who, if they get run over by a train you'd shrug and say "oh well, bye."