Janey undergoes, as if in a fairytale, a nightmare journey of exploitation - first incest, then abortions, a job selling cookies to the chi-chi bourgois of Brooklyn, a one-sided love affair with the leader of punk gang THE SCORPIONS, and finally is sold into the white slave trade in the middle east. Along the way she grapples with the cultural message of The Scarlet Letter, falls in love with Jean Genet, and angrily ridicules Erica Jong - the famous rich white face of 1970s feminism.

Pulsating with the influence of William S. Burroughs, the narrative is a patchwork mish-mash of prose, poetry, drama, literary plagiarism and illustration - childlike sexual drawings pepper the book, along with Acker's surreal, minutely detailed, annotated 'dream maps'. Exploring feminism, punk, the idea of the "literary canon" and the United States of America, Blood and Guts in High School has lost none of its power to shock.