[1][2] The book has been challenged in some schools due to its title and language,[3] and deals with the theme of teen bullying and its effects on the individual and their lives.

This horrifies Piddy, as she'd rather spend her time working at a local hair salon and trying to find out more about her absentee father rather than trying to prevent herself from getting hurt.

She's later horrified when she discovers that Joey has first hand knowledge of abuse, as his father frequently beats his mother- to the point where she has ended up in a hospital.

The following day Joey tries to convince Piddy to run away with him to Pennsylvania, as he knows that his mother will only keep returning to her abusive husband and he does not want to continue to witness her beatings.

The book ends with Piddy adjusting to life in her new school, finding that she has been accepted to a prestigious academy, and happily celebrating with her mother and everyone else in the salon.

[3] In 2013 Medina was invited to be a guest speaker at an anti-bullying event at a Cumberland County school in Virginia, but was later told that she could not display the book title, cover, or use any sort of coarse language during her speech.

"[3] The Kids' Right to Read Project heavily criticized the school board's choice to rescind Medina's invitation and restrict discussion to not potentially include coarse language, writing "Censoring frank discussion about the language of bullying and the powerful effect of certain words sends a message to students that these subjects and, by extension, their experiences, are not to be discussed; that though they may face cruel language and abuse in their daily lives, they are not mature enough to participate in a realistic conversation on this subject.

[16] In February 2017, it was reported that streaming service Hulu had ordered a television series adaptation of the novel with executive producers including Gina Rodriguez and Eugenio Derbez.