As rewak says, the style is quite dense, with the narrative drive often broken up with the thoughts and memories of the characters. Its well written, if a bit self-conciously literary and precious for my taste.
Its set on Labrador, and the specific ways of living on the island are central to the texture of the prose. .
The central character is born hermaphrodite, but does not learn this until s/he reaches adolescence. Wayne/Annabel - and the other main characters - are portrayed with respect and delicacy
To my mind the novel isn't especially about the issue of intersex or gender. It's as much about how life and its adversities affect our hopes and dreams as we grow older and more experienced; how we come to terms with things as they are rather than how we imagine they will/should be.