The current LGBTQQIAA acronym has been growing in length and complexity since the early days of the gay and lesbian civil rights movement. Each letter of the acronym reflects the addition of a group who felt marginalized and left out, not fitting into the communities described by the existing letters. The addition of new boxes, however, has created increasing confusion and sometimes feelings of separation from each other. In this book, Vanderburgh has explained each letter from an "insider" perspective while also providing historical context explaining how we got from there to here.

As a queer transman who transitioned out of lesbian community and now particiaptes in gay male community while married to a genderqueer woman, Vanderburgh is in an excellent position to explain the many letters to each other. In addition, his work as a therapist allowed him deep insight into the various letters that don't reflect part of his identity. At 61, Vanderburgh came of age in the San Francisco lesbian community of the early 1970s.

Personal stories are the best way to convey the experience of identity, and Journeys of Transformation contains 18 such stories:

The Twentieth Generation: Joe and Vince transitioned in the 1950s.
The Next Generation: Dana, now 26, transitioned in high school.
I'm One, Too: Mary is a lesbian who experiences the fall-out when she falls in love with a man.
That Wasn't It After All: Lesley realizes she made the wrong decision in becoming David.
The Inherited Relationship: Belinda realizes she inherited her relationships from her former male self Barry.
I Believe in Miracles: Audrey lives as a bi-gendered person internally, remaining a man to preserve her marriage.
The Joy and Pain of Starting Over: Phyllis came out as a lesbian in the 1990s, losing her best friend in the process.
Subject to Change Without Notice: Carmen goes on her own journey, remaining married as her husband transitions.
A Brother's Journey: Peter is a cisgender gay man who comes to term's with his sibling's convoluted journey.
It Gets Better: Seda and Kristin remain married through transition, despite Kristin losing attraction for Seda.
A Non-Traditional Non-Traditional Family: Peg, a lesbian psychiatrist, comes to terms with owning a lesbian identity in the 1960s.
Call me Yommie: Emily's family gradually adjusts to her transition.
The Invisible (Trans)Man: Kevin is a transman who finds it hard to accept that he's trans, and wishes he was cisgender.
Better Late Than Never: David is a 70-something gay man who tried everything not be gay.
Transcendence Through Music: Karen is a mid-fifties transwoman who is avoiding transition until after retirement.
The Exceptional Transition: Trina's transition defies every stereotype possible.
The Mother of the Bride: Rache's life turns upside down when her oldest child transitions.
Once Upon a Time: Jean learns after he died that her lifelong best friend Howard was a gay man.