In that book, Bailey summarized research on Blanchard's transsexualism typology in a way that Dreger says is scientifically accurate, well-intended, and sympathetic, but insensitive to its political implications.

The larger audience and potential to influence public beliefs about transgenderism led a prominent transgender activist, Lynn Conway, to campaign against Bailey.

[3] Dreger wrote that some activists had turned their horror at Bailey's findings into a very public vendetta against him and his family, including thinly veiled allegations that he sexually abused his children.

Moreover, Dreger observed that "the most interesting mail, from my perspective, came from trans women who wrote to tell me that, though they weren't thrilled with Bailey's oversimplifications of their lives, they also had been harassed and intimidated by Andrea James for daring to speak anything other than the politically popular 'I was always just a woman trapped in a man's body' story.

The New York Times described the book as "a rant, a manifesto, a treasury of evocative new terms (sissyphobia, autogynephilia, Phall-O-Meter) and an account of the author's transformation" from activist to scientist and back again.