I think my thoughts on this is that it is a manga, but it isn't a manga the way people think of a manga usually are. It has all the pieces, text, story, and art to go along with that, but it doesn't follow the narrative beats people assume from manga. This is a manga autobiography, and there are different expectations from that compared to other manga.
What I can say is that the raw emotion is powerful here. There are discussions of sex and sexuality that most people don't cover. But what I found most striking was the descriptions of developed shame, the concepts of being what you are expected to be in certain ways... these are visceral, bleeding parts of the queer experience and I think it's overall a very powerful piece of writing. It's uncomfortable in many ways, because that's life. Life's uncomfortable. This is honest. It's frank.