Starred reviews from Publishers Weekly and Booklist * YALSA Top Ten Quick Pick for Reluctant Readers * ALA Best Fiction for Young Adults List * 2017 Rainbow List

A sharply honest and moving debut perfect for fans of The Perks of Being a Wallflower and Ask the Passengers.

Riley Cavanaugh is many things: Punk rock. Snarky. Rebellious. And gender fluid. Some days Riley identifies as a boy, and others as a girl. But Riley isn't exactly out yet. And between starting a new school and having a congressman father running for reelection in über-conservative Orange County, the pressure—media and otherwise—is building up in Riley's life.

On the advice of a therapist, Riley starts an anonymous blog to vent those pent-up feelings and tell the truth of what it's really like to be a gender fluid teenager. But just as Riley's starting to settle in at school—even developing feelings for a mysterious outcast—the blog goes viral, and an unnamed commenter discovers Riley's real identity, threatening exposure. And Riley must make a choice: walk away from what the blog has created—a lifeline, new friends, a cause to believe in—or stand up, come out, and risk everything.

From debut author Jeff Garvin comes a powerful and uplifting portrait of a modern teen struggling with high school, relationships, and what it means to be human.

“Riley is a smart, funny, sharp-eyed force” — Publishers Weekly (starred review)

“One of the first YA books to deal with the complex issue of gender fluidity…Riley’s emotional life and personal growth shed welcome light on a hitherto obscure subject.” — Booklist (starred review)

“Vibrantly imagined…a welcome mirror for gender-fluid teens.” — Kirkus Reviews

“With a main character who truly deserves to be called unique, combined with heartbreak and triumphs that are universal, this unforgettable book made me laugh, and also cry: Garvin’s powerful new voice rocks!” — Lissa Price, international bestselling author of Starters

“Riley Cavanaugh is a sharp, funny, powerful voice for those who haven’t quite found theirs yet. Both highly entertaining and highly necessary, Symptoms is the kind of book that makes you a better human for having read it. I loved it.” — Dahlia Adler, author of Under the Lights and Just Visiting

“A moving portrayal of what it means to be different, yet the same, all at once. Jeff Garvin has written a beautifully thoughtful book.” — Renee Ahdieh, author of The Wrath and the Dawn

“An important introduction for readers who know little about gender fluidity and a welcome nod to those who may be experiencing similar feelings.” — Bulletin of the Center for Children’s Books