Shuuichi Nitori, an effeminate fifth grader, is regarded by most as one of the school's prettiest girls, yet to her dismay, she is biologically male. Fortunately, Shuuichi has a childhood friend who shares similar feelings of discomfort regarding gender identity: Yoshino Takatsuki, a lanky tomboy who, despite being biologically female, does not identify as a girl. These two friends share a similar secret and find comfort in each other; however, their lives grow even more complicated when they must navigate the unfamiliar environment of a new school, try to make new friends, and struggle to keep old ones. Confronted with nearly insurmountable odds, they must learn to cope with the harsh realities of growing up, being transgender, relationships, and acceptance. Praised as a decidedly serious exploration of gender identity and LGBT struggles, Takako Shimura's Hourou Musuko follows Shuuichi and Yoshino's attempts to discover their true selves as they enter puberty, make friends, fall in love, and face some very real and difficult choices.