Several times - Jess is raped by football players in her highschool, and she and her friends from the gay bars are raped and sexually assaulted by the police on many occasions.
Near the beginning of the book Jess is sent to a mental hospital for wearing mens' clothes, and near the end of the book she visits her friend Butch Al in a mental hospital.
For some of the novel, Jess goes by "he/him" pronouns for her own safety in the world of work, and flees when one of her friends accidentally refers to her as "she" in front of her colleagues.