"The book is an autobiographical memoir depicting the real-life struggles and triumphs of Imani Singh, a transgender woman. Focusing on her trials and tribulations, The Nerve gives us a raw look at Singh's exploration of gender identity and sexuality as she details various painful aspects of her life as a trans woman.
Singh begins the book by recounting various moments of childhood trauma, from being molested at the age of four to experiencing gender dysphoria in first grade, household domestic violence, and struggles with religion, parental abandonment, abuse, and substance use. Singh also describes the confusing experience of going through male puberty as someone who feels female.