Supplemental Needs: A Novel portrays a young family whose lives change on learning through prenatal genetic diagnosis that their baby will have Klinefelter syndrome, most likely causing some degree of disability, as well as infertility and possible sexuality issues.

Rachel and her husband are delighted with a pregnancy following years of infertility. But their joy is shattered learning that their baby boy has an extra X chromosome. They need to decide quickly about continuing the pregnancy. Genetic counseling cannot predict how his life will proceed because the range of functioning for this diagnosis extends from barely affected to significant intellectual disability. A geneticist advises them to have an abortion. Nonetheless, the Golds continue the pregnancy, anticipating a mostly normal childhood for their son, with possible developmental delays. Jacob’s development begins to depart from the typical after his first birthday, and by the age of two, Rachel and Dave are navigating the world of special needs parents. At the same time, Rachel is engulfed in a career crisis, and Dave’s brother confronts increasing challenges to his commitment to Orthodox Judaism. The novel deftly addresses disability and genetic diagnosis, sexuality, and family dynamics.