A week later, Donald, Maryanne, and Robert terminated health insurance coverage for Fred III's then 18-month-old son, William, who suffered from epileptic spasms caused by cerebral palsy.

The documents were used for a 2018 article by David Barstow, Susanne Craig, and Russ Buettner that detailed financial fraud by Trump, for which the authors won the Pulitzer Prize for Explanatory Reporting.

[13] In Part One: The Cruelty Is the Point,[14][15] the author describes the character of the family's patriarch, Fred Trump Sr., and attempts to elucidate how his treatment of his children has had a lasting impact on them.

[13][20] The entire Trump family's constant denigration of Fred Jr.'s chosen profession contributed to his struggles with alcoholism and other issues in the 1970s, leading to both his aviation career and marriage failing.

[21] In Part Three: Smoke and Mirrors, the author details how, as the influence of Fred Sr. waned, Donald Trump struggled to operate his business without the knowledge and connections his father provided.

[7] In Part Four: The Worst Investment Ever Made, the author provides her view of the period when Donald Trump mounted a successful campaign to become President of the United States.

Mary again draws on her training as a psychologist to claim that her grandfather Fred Sr. initiated a direct line to more power actors, all enabling Donald's worst instincts to serve their respective needs.

[18] She states that, due to her uncle's psychological capacity being forcefully stopped from fully developing at a young age by his father, he remains extremely susceptible to manipulation by more capable local and foreign actors.

[24][25] On August 22, 2020, Mary released tape recordings of her conversations with her aunt Maryanne Trump Barry, Donald's sister and a former United States federal judge appointed to judicial offices by Presidents Ronald Reagan and Bill Clinton.

[27][28] In the recordings, Barry expresses horror at Donald's immigration policy of separating children from their parents, disparages his religious supporters for their lack of compassion, and laments his cruelty and phoniness.

[48] Simon & Schuster initially set a release date of August 11, 2020, and gave the exclusive report about it to The Daily Beast, which published an article about the book on June 15.

[57] Robert Trump filed suit on June 23, attempting to secure a preliminary injunction and a temporary restraining order to block publication, citing Mary's NDA.

[60] A New York appellate justice, Alan D. Scheinkman, on July 1, reversed the lower court's decision, finding that Simon & Schuster was not a party to the NDA, was not subject to prior restraint and pre-publication injunction considering the First Amendment, ruling that Simon & Schuster could proceed to publish the book pending a hearing on July 10, leaving Mary enjoined from book sale activities, and leaving open the question of whether Mary had violated the NDA.

[20] Jennifer Szalai of The New York Times praises the author's courage and determination, describing the book as "written from pain and is designed to hurt,"[23] the latter part of the characterization Mary later rejects.

[19] Megan Garber, writing for The Atlantic, agreed with Mary's observation that Donald Trump has allowed for similarly toxic family dynamics to be brought to the national stage.