Raised as a boy and home-schooled by her single mother, Jessie Jacks is unlike other girls and boys. Jessie is an intersex child born both male and female, although her countenance and physical appearance are strikingly female. After the death of her mother, she is placed in the care of her aunt where she is faced with a whole new set of circumstances that she must adapt to - high school for the first time, issues of sexual identity, peer pressure, social prejudice, first love, and the biological, physiological, and psychological changes she experiences as puberty raises its ugly, or in this case, beautiful head. Jessie becomes the target of Sheryl North, a vindictive, narcissistic leader of the elite, Bitch Clique. With the help of her boyfriend, Butch Staples, the school bully and several of his friends, Jessie is assaulted and humiliated in front of the rest of the students at the Halloween Dance. Later, in the emergency room at St. Theresa's Hospital, Jessie performs a desperate act of self-mutilation. With the help of family, friends, and devoted psychiatrist, Ellen Eckhart, Jessie undergoes sex reassignment surgery to repair the damage she had inflicted upon herself, but more importantly, to make her a complete female.