The novel follows its transgender protagonist to the age of 10 - before puberty hits but not before questions of surgery arise. The mother, an ER doctor, is inclined to search for clinical "solutions" while the father, a novelist, seeks to write a fairy tale ending.
Poppy's four older brothers are smart and fiercely protective of their little "sister", frequently offering perspectives their parents hadn't considered on the ramifications of their decisions. But they are all affected profoundly by her journey in individual ways. The eldest believes his parents' decision to put their youngest child's needs ahead of his own means he is loved less.
Frankel says parenting a transgender child has taught her to keep an open mind about what the future holds.
"That's probably a good lesson for all parents. I have no idea who my daughter's going to be at 10 or at 16 but that would be true anyhow. Her being trans helps me to keep that at the forefront of my mind."
While Frankel has only one child, she says a large family was always part of the original seed of the novel because she loves big families and the way a family can become a character in itself.
"My agent tried to talk me out of it because she felt there was too many characters, but I was wed to all of them. Because this is a book about a families and secrets it applies to everyone. The point is not that we should be more open to transgender people; rather it's that we should be more open to all people, period.
"I hope the transgender aspect serves as a metaphor for anything that's not quite the norm. Politics in the United States has gone to the dark side and more people than ever need this message. We need to love more, tolerate more and open our minds more because that's what will make the world a better place."
Frankel taught writing at the University of Puget Sound until five years ago when she gave up her job to write full time. She writes at home from the moment her daughter gets on the school bus to the moment she's dropped back.
"School does not meet for as many hours as one would hope. The nice thing is its very motivating but it does make for very frenzied days."
The novel is Frankel's third. The Atlas of Love, about three young friends who decide to raise a child together, was a hit with lovers of "chick lit" while the second, Goodbye For Now, about a girl who copes with grief by interacting with a computer-simulated version of her dead grandmother, garnered praise from The New York Times.
Frankel says the writing experience has been different each time. "I'm at the start of the next one now and it's such a long process that by the time I get back to the beginning again I feel like I've forgotten how to do it."
Lowdown: This is How It Always Is
by Laurie Frankel
(Hachette, $35)