After I finished reading "As Nature Made Him" I couldn't stop thinking about how hard it had to have been for David growing up.  As the book progressed it was obvious that as David's life went on, the troubles didn't exactly go away easily.  All because of a freak accident David's and his whole family's life would never be the same.  It was very hard for me to read and get through this book and not only because of my reading level, but also because the book described many scenarios in great detail.  Gender construction played a very important role in this book, but not in the way that some other material we have used had.  In the movie Gamer, and the graphic novel Surrogates, the gender construction was very much focused on being who you want to be while in this book, the gender construction took place when David was growing up and being taught to act like and dress like a girl.  The thing I've noticed about gender construction is that it is almost always used to mask something.  In David's case it was used to mask a mistake and give him a normal life, then later in the book gender construction happens as David rejects being a female and returns to being a male.