Exactly how steamy is this story?
PG-13
There isn't a whole lot of sex in this book, but there's a lot of scary fallout from sexual relations. Skloot mentions the sexually transmitted diseases passed to Henrietta from Day's flings, eventually leading to the HPV infection that caused her cancer. Henrietta also unknowingly passed neurosyphilis to her daughter Elsie, which was at least partly responsible for her illnesses and mental impairment. Then there's criminal sexual behavior—like Galen's molestation of young Deborah and the male cousins who try to "mess" with the young girls in the family.
We also see the complications and birth defects that can result when first cousins have children together, as was common in Henrietta's family. Sexuality in this book is never uncomplicated—but it's also not particularly in-your-face.