[3] Gansworth originally qualified in electroencephalography, considered a profession useful to his nation; however, he went on to study literature and to continue a lifelong interest in painting and drawing.

His critically acclaimed first young adult novel, If I Ever Get out of Here, deals with the friendship between two boys, one a resident of the Tuscarora Nation, the other living on the nearby Air Force base.

In a starred review, Booklist stated that the book succeeded in "sidestepping stereotypes to offer two genuine characters navigating the unlikely intersection of two fully realized worlds.

Gansworth himself sees the two themes most important to his work as being "the ways history informs the present" and also a strong interest in entertainment culture.

"[6] His nonfiction book Apple (Skin to the Core) (2000" won a Michael L. Printz honor for best young adult writing.