This Is How It Always Is is the heartwarming tale of an American transgender girl and her family.

Claude, born the youngest of five sons to Rosie, a doctor, and Penn, an aspiring novelist, decides in pre-school that he would rather wear dresses and be a girl.

His parents support his decision and eventually relocate the family from the Midwest to Seattle so Claude, now Poppy, can grow up in a more progressive environment.

Chronicling the family's joys, fears and triumphs over a roughly 10-year period from Claude's conception to Poppy's pre-pubescent years, the book grapples with some difficult questions.

Are the parents of transgender children doing the right thing by being "supportive"? And should these children be placed on hormone-blockers?

In her note to early reviewers at the start of the book, Frankel reveals that it was informed by personal experiences - she has a daughter in second grade who "used to be a little boy and is now a little girl, a transgirl".

It was brave of her to confront a topic so close to home. But the voice of the author often seems entangled in the story itself - one often gets the sense that it was written for therapy's sake, at the expense of literary merit.

The book is appropriately prefaced with the epigraph: "Do I contradict myself?/ Very well then I contradict myself,/ (I am large, I contain multitudes.)"

But taking a leaf from a famous Walt Whitman poem isn't quite enough to exempt it from the problems of excessiveness.

With disparate thematic threads clamouring for coherence, and extraneous dialogue and remarks that spell out the obvious, the book feels cluttered and could do with plenty of trimming.

Frankel is susceptible to a few authorial tics that may irritate readers, notably her tendency to end paragraphs with a sense of foreshadowing.

There are also some awkward turns of phrase. Rosie's children react to ice cream with "the relief of refugees".

And then there is part three of the novel, where Rosie and Poppy, both feeling troubled, head off to the magical world of Thailand where their spirits are lifted after they learn a thing or two from some warm-hearted locals - one of whom, incidentally, is a "katoey" (ladyboy). Now, this just borders on cultural cliche.

Still, it is hard to criticise Frankel's book without that creeping feeling that you are being intolerant yourself. Why should a book about being who you want to be dress itself in more stylised or subtle writing because some readers think so?

And the novel does yield some interesting insights into what raising a transgender child might be like: "Whatever link you got for free that picked the appropriate pronoun whenever one was called for was permanently decoupled, and suddenly Penn's mother-tongue was foreign."

This Is How It Always Is has its flaws and is best avoided by literary snobs. Nevertheless, it is a tender, endearingly human piece of work that may well tug at the heartstrings of many.

Toh Wen Li

•If you like this book, read: The Atlas Of Love (Griffin, $26.91, Books Kinokuniya), Frankel's first novel, about a graduate student who becomes pregnant.