The language in this, as is usual for Crutcher, is "gritty and realistic", which means there are multiple uses of profanity, including the f-bomb. Situations found in young adult fiction are notably absent, but there is a fair amount of descriptions of the abuse Annie and Frankie have suffered.
The inclusion of swimming is fantastic-- aside from this author's Whale Talk, Calame's Swim the Fly, Crossan's The Weight of Water, Dominy's A Matter of Heart and Luurtsema's Goldfish, there aren't that many books about swimming published for young adults. Readers who like to read about people whose lives are worse than their own (and there are a lot of readers who do!) will find that Crutcher's book, while dealing with serious issues, treats them with constructive levels of hope. It's easy to envision a successful life for Annie, even though it might not be an easy one.