Signs that everything wasn’t quite right came early and often for fAe. Though he was “born with girl parts,” a trip to the girls’ room on the first day of school was met with terrified screams. At age three, industrious little fAe dreamt of devising a synthetic penis, which he hoped would let him pee like a boy. Early on, fAe found some comfort in a lesbian identity but knew this was not his true self. Years of introspection led to the undeniable conclusion that fAe was a man mistakenly endowed with a woman’s body. His caring —but somewhat careless — brother notes that these biological errors simply occur sometimes, likening fAe’s condition to that of a boy from a recent magazine article he read—a boy born with fins for feet.

Unfazed, fAe undertakes a regimen of testosterone injections, leading up to a painful and irreversible double mastectomy (which he gleefully refers to as “getting my breasts chopped off”). With the support of friends and family, fAe completes his gender transformation, but difficulties arise along the way. Daily struggles pile up beside more serious ones: How does a recent graduate raise huge sums of money for an “optional” procedure? How can fAe’s mom learn to love a son when she had raised a daughter? Now more outwardly male, how does fAe reconcile the female traits he wants to retain? And, perhaps most daunting of all, how does fAe transform, not in New York or San Francisco, but in rural Pennsylvania? — ILYA TOVBIS