Bah. This is not what I was expecting, but I guess it's needed for awareness. So, a regular boy is forced to become transgender, and as a transgender myself, is not a fate I would wish on anyone. Seems like this manga is taking a tone grounded in Japanese realism.
Japan, while I love anime and manga, is NOT a safe place for real world LGBT. It's all thought of as things that "only happen in fiction", which is demoralizing and depressing for anyone who *is* LGBT in Japan.
*sigh*