Set against the tensions of the Vietnam War era and the beauty of the Pacific Northwest, high school lovers Tessie Faber and Derek Hemphill become enmeshed in a 1960s story of sexual trauma that profoundly alters their lives.

Together, they explore hidden childhood memories and find themselves up against a man's world, where abused women are victimized in a society that doesn't acknowledge the seriousness of their situation. As Tessie reveals the subterranean parts of her life, Derek's eyes are opened, and they try to build their relationship upon empathy and equality and healing-a kind of psychological Truth and Reconciliation partnership.

Inspired by Thomas Hardy's Tess of the d'Urbervilles, Underwood's Always, Tessie is a modern reflection of what women faced before the contemporary #MeToo movement and the now repealed Roe versus Wade abortion ruling. It invites today's readers to ponder what has and has not changed in the circumstances of abused and traumatized women and other marginalized groups throughout history.