The world is mostly the same as it ever was in one timeline, but there was a difference. With only one little tweak, a monster girl named Susie was instead born as a monster boy named Sam. The story follows Sam as he struggles to cope with nicotine addiction, alcoholism, loneliness, poverty, starvation, the confusing journey of growing up, and his mother.
Tags, archive warnings, etc. are bound to change over time.