Sylvia wishes that hormones weren’t such finicky things. She has Turner Syndrome and will need estrogen supplements to develop normally—whatever that means, since almost everyone around her seems to be hormonally imbalanced.

Sylvia is twelve and she wants a horse but a few things are getting in her way. For one, she seems to be stuck in the body of a six-year-old. Sylvia has an undiagnosed medical condition, which makes her very short, with funny ears and strange hands. The kids at school call her Pygmy Chimp. Grandpa has secretly promised to buy her a horse as soon as she grows as tall as his shoulder. Sylvia does everything she can to increase her height, including adhering to an unconventional stretching regime.

In this sequel to Born That Way, Sylvia, fourteen, is now taking medication for Turner's Syndrome, the genetic disorder with the missing X chromosome. Without treatment, Sylvia will remain short, undeveloped and infertile, and the object of ongoing teasing at school. Unfortunately Sylvia experiences serious side-effects to her medication and grapples with what it means to become "normal". If the hornless unicorn she dreams about is still very much a unicorn, then is Sylvia still a young woman when she has no ovaries?