Symptoms of Being Human

Riley Cavanaugh is a gender fluid teenager whose sense of gender identity shifts regularly; they are sometimes a boy, sometimes a girl, or neither. Riley speaks in first person and does not call themself any third person pronoun. Riley is not out of the closet their peers or their father, a Senator, or their mother, feeling their identity is hard to explain or will not be accepted. Though Riley feels masculine or feminine to different degrees at different times and struggles with dysphoria, they prefer to appear androgynous so that their gender will not be assumed. After moving to a new school a struggling with people's perception of them and being bullied, Riley begins to write an anonymous blog under the pseudonym "Alix" where they can write about gender fluidity, even giving advice to readers facing similar problems. While the blog is at first a liberating outlet, things take a turn for the worse when an anonymous person claims to know Riley's real identity and threatens to out them.

Garvin states that his goal in writing the book was to emphasize how hard it is for gender fluid people to live in a world that is heavily influenced by the construct of gender.[3] He added that:

It’s important to point out that [in real life], most gender fluid people can’t avoid gendered pronouns—they’re everywhere... my point: language is a powerful tool for shaping thoughts. So, if a nonbinary person asks you to address them using a pronoun that seems unnatural or awkward to you, honor their request! The awkwardness will pass, your friend will feel respected, and you’ll have taken a significant step toward rewiring your brain and the brains of those with whom you speak.

This novel was a first in the representation of gender-fluid people, and was well received by critics and audiences alike.

In a review for Lambda Literary, Sawyer Lovett writes, "There are some tropes that are hard not to call upon in a coming out novel–the family strife, the physical violence, the unexpected love story. But those tropes exist for a reason: queer people are often victims of assault, sometimes our parents aren’t cool with our gender identities or sexuality, and love rules."[2]