Eventually, you can't help but figure out that, while gender is a construct, so is a traffic light, and if you ignore either of them, you get hit by cars. Which, also, are constructs.

Maria is stuck in a dead-end job, a relationship without prospects, and a shitty New York apartment. She may be depressed and have a substance abuse problem. Who knows. Also, she should probably inject her hormones.

Binnie's novel felt personal, in the sense that Maria's various ruminations on gender and her struggle with her trans identity (how to reconfigure gender, trans women's unique position in the queer stratosphere, and how to teach yourself to feel after disassociating for the large part of your life).
What was slightly odd, maybe, was the second portion of the novel. Maria, post-break up, goes on a road trip. In Nevada, she meets a potentially closeted trans woman, who she then attempts to aid in the process (more so to heal her own traumas than out of the goodness of her heart). This rings true for Maria's selfish streak. I suppose this plot aimed at displaying how, despite mentors and guides, every closeted person has their own journey (as our closet case refuses to be helped and ultimately returns home to his girlfriend, unchanged). Still, that bit threw me at first.

This novel reads like an early-00s indie movie. Sadly, I have nothing to compare it to (due to my own blind spots or due to Hollywood's inability to film more trans-centric movies, or maybe both). Definitely recommend if you're a lit-fic, stream-of-consciousness, character over plot novels.