In terms of genre, you will not read anything like this novel, but it's most accurate to call it an alternate history western and leave it at that. The major focus is on women's lives, and it uses the alternate history elements to tell a very modern story about women and AFAB people who have been marginalized by history. It has the rare hat trick of discussing very modern topics -- mental illness, queer topics, the role of women in society-- in a way that feels utterly true to the historical conventions it sets up. The characters don't know what the gender binary is, but the story is structured so no one is misgendered. The characters don't know what being bipolar is, but the story still treats these issues with care. The first person prose never obscures when it should illuminate; unlike many first person novels, it never takes the easy way out. Overall, an excellent novel that I recommend to anyone who loves stories of women who get their hands dirty.