Effeminate fifth grader Shuuichi Nitori is widely seen as one of the prettiest girls in school, but to her own dismay, she is biologically male. Fortunately, Shuuichi has a childhood friend who shares similar feelings of gender discomfort: the lanky tomboy Yoshino Takatsuki, who is biologically female but does not identify as a girl. The two friends share this secret and find comfort in each other, but their lives grow more complicated as they navigate a new school, try to make new friends, and hold on to old ones. Faced with daunting challenges, they must learn to cope with the harsh realities of growing up, being transgender, relationships, and acceptance.
Praised as a serious exploration of gender identity and LGBT struggles, Takako Shimura's Hourou Musuko follows Shuuichi and Yoshino as they seek their true selves through puberty, making friends, falling in love, and confronting very real and difficult decisions.