Published in 2016, the young adult novel Symptoms of Being Human by musician and author Jeff Garvin focuses on the coming of age of gender-fluid teenager Riley. In addition to other awards, the book was a Lambda Literary Award Finalist, was included on the 2017 Rainbow Book List, and was named the Nutmeg Book Award Winner.

Note: Out of respect for the main character’s gender fluidity, Riley Cavanaugh is referred to with the singular pronouns they/them/theirs.

Plot Summary

Riley Cavanaugh, the 16-year-old child of Congressman Sean Cavanaugh and schoolteacher Sharon, is gender fluid, which for them means that they fluctuate between identifying as a boy or girl—but they haven’t come out yet. Unable to show neither their masculine nor feminine sides for fear of being perceived as only one or the other, Riley dresses as ambiguously as possible.

Riley transfers to public Park Hills High School, partly as a publicity stunt to help Riley’s father’s reelection campaign, and partly because Riley suffered increasing bullying and gender dysphoria at their old school and attempted suicide.

At Park Hills, running back Jim Vickers and his girlfriend Sierra Wells bully Riley for their ambiguous appearance. Feeling hopeless and alone, Riley takes the advice of Doctor Ann, their psychiatrist, and begins blogging about their experiences as a gender-fluid teenager under the pseudonym “Alix.” Their blog becomes national news when a transgender girl thanks it for saving her life.

Riley makes friends with “Solo,” Jason Solomona, a boy on the football team with an affinity for Star Wars, and Bec DeLucca, a goth girl struggling after the death of her younger transgender sister. On a date with Riley, Bec takes them to the Q, an LGBT support group. There, Riley meets Mike/Michelle Weston, who correctly guesses that Riley is “Alix.” Mike/Michelle asks Riley to be a panelist for an upcoming transgender health conference, and Riley says they’ll consider it.

The sense of belonging Riley is starting to feel shatters when they start receiving threatening anonymous messages on their blog. Unbeknownst to Bec or Riley, Bec’s brother, Erik, has hacked Riley’s computer and showed the blog to Jim Vickers. Though the anonymous sender may or may not be Vickers, it is definitely someone from school—the messages use Riley’s real name, and Riley’s locker is vandalized with the words from one of the anonymous messages.

On the night of Riley’s father’s last big fundraising dinner for his reelection campaign, Riley’s family is bombarded by press after dinner. Their questions reveal that Riley has been outed to the press. At home, Riley comes out to their parents as gender fluid, and Riley’s father is angry that Riley has been posting about their gender identity online. Unable to handle the conflict, Riley drives off looking for Bec.

Not finding Bec at home, Riley heads to an abandoned building Bec once took them to, injuring themself and being knocked unconscious when they try to jump onto the fire escape from the hood of their mother’s car. When they regain consciousness, Riley is cornered by Jim Vickers and his friends, who followed Riley from Bec’s house. The three sexually assault Riley, fleeing when Solo and Bec interrupt them.

Solo and Bec take Riley to the hospital to receive treatment for their injuries, and Bec, blaming herself, leaves and refuses to answer any calls. After a three day stay in the hospital, Riley is discharged, feeling guilty for the stress they have put on their parents and the impact on their father’s campaign. Riley refuses to speak to the police.

Riley and Bec reconcile. When Riley returns home, they talk with their parents, who are supportive, but ask Riley to help them understand gender fluidity. Riley asks their parents to sit with them while they call the police to give a statement regarding the assault.

Jim Vickers is arrested for the assault, but the authorities are unable to find any evidence connecting him to the anonymous messages to add additional charges. Riley returns to school, and though there is some level of attention on them, they are for the most part left alone. When classmate Casey Reese approaches Riley to tell them that they have given him the courage to come out as transgender, Riley makes a call to Mike/Michelle Weston to sign up as a panelist for the conference. The novel ends with Riley speaking at the conference with their family and friends in the audience.