Rules for 50/50 Chances

Book review by
Andrea Beach, Common Sense Media
Rules for 50/50 Chances Book Poster Image
Risk of disease is fresh twist in romance/medical tale.

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The parents' guide to what's in this book.

Educational Value

Coping with genetic disorders, especially Huntington's disease and sickle-cell anemia. Some facts about rare genetic disorders and the mutations that cause them. Boston-area geography and culture. Names of ballet moves, glimpses into the world of studying and performing ballet. Web sources in the back for further research into Huntington's disease. Some of the world's great train journeys listed, what it's like to take a cross-country train.

Positive Messages

There's a lot of uncertainty in life; don't waste too much time and energy looking for certainty. Try to experience life in a "normal" way, without all the worry about what might or might not be. Enjoy the journey; don't just move from one place to another or from one thing to another. It's OK to talk about race, especially how it affects our experiences. We should strive for a world not where race doesn't matter but where no one is at a disadvantage because of race.

Positive Role Models & Representations

Rose is a smart, college-bound senior. She studies ballet and is seriously considering pursuing a career as a ballet dancer. She has ups and downs but overall copes well with having a mother who has a degenerative disease. She's also a worrier. Caleb is smart, artistic, honest, loyal, and a better example of handling family members' illnesses. Rose's parents are loving. Her father is a good model of patience and support, both for his wife, who has Huntington's disease, and for Rose as she comes of age.


Mentions of drawing blood for a medical test, blood from an accidental injury, domestic abuse. A child with sickle-cell anemia in extreme pain is briefly described.


Older teens in a serious relationship kiss and make out several times, and once or twice it's briefly described. They have sex, which isn't directly described, but the making out leading up to sex is briefly described. Getting over the awkwardness of using a condom is mentioned.


"F--k" and variations, "ass" and variations, "bulls--t," "bitch," "hell," "crap," "damn," "butt," "s--t," and "goddammit."


Various food, beverage, and consumer products mentioned to establish mood, location, or character. Part of the story features a trip on Amtrak's California Zephyr.

Drinking, Drugs & Smoking

Adults drink beer at a celebration. Dad's past occasional pipe smoking associated with a pleasant smell. "Killer pain medicine" mentioned once for a sickle-cell patient. Medication for mom, who has Huntington's disease, mentioned briefly once or twice.

What parents need to know

Parents need to know that Rules for 50/50 Chances is a coming-of-age romance with a healthy dose of medical drama. High school senior Rose's mother has Huntington's disease, and Rose has a 50/50 chance of carrying the genetic mutation that can cause it. Older teens in a serious relationship kiss, make out, and have sex. Using a condom's mentioned, although the sex isn't directly narrated. Adults and teens use strong language occasionally, including "f--k," "s--t," and variations of "ass." Love-interest Caleb is a strong African-American role model, patiently helping Rose navigate her uncertainty and supporting his own family through their medical crises. It may get kids thinking about coping with illness, racial equality, dealing with uncertainty, train travel, and more.

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What's the story?

High school senior Rose Levenson's mother has Huntington's disease, and Rose knows there's a 50/50 chance she's inherited the genetic mutation that can cause it. As she watches illness steadily eat away at the person who once was her mom, she feels like she's watching her own future in a crystal ball. With those odds hanging over her, Rose feels like she can't make any plans for her future, such as where to go to college or whether to pursue ballet, unless she knows whether she'll get Huntington's herself one day. So against conventional wisdom and her parents, Rose decides that as soon as she turns 18 in a few months, she'll take the blood test that will tell her if she carries the mutation. Enter Caleb, the handsome, smart guy whose own family battles sickle-cell anemia. What do the RULES OF 50/50 CHANCES say about falling in love?

Is it any good?

Debut-novelist Kate McGovern adds an extra twist to the now-standard, terminal-illness twist on this mixed romance and coming-of-age story: This time it's the mom who's ill. Teens will relate to Rose's struggles to make decisions about her future, and there's food for thought about issues of race, coping with a loved one's illness, love, and uncertainty. But as even love-interest Caleb says, Rose is exhausting. It's occasionally frustrating and tiresome watching her constant hand-wringing, which keeps her from being an entirely likable narrator.

The romance itself is fresh and feels realistic, and the illnesses are nicely handled: serious and refreshingly honest without being overwrought. It may not be the next Fault in Our Stars, but teens who like their romance with plenty of medical drama on the side will enjoy following Rose as she learns to enjoy what life has to offer.

Talk to your kids about ...

  • Families can talk about why medical issues, especially terminal illnesses, are often a big part of the books and movies we love. What do medical issues add to, or take away from, the story? What would Rose be like if her mother didn't have Huntington's disease?

  • How much did you know about genetic disorders before reading Rules for 50/50 Chances? Did anything about them, or about the characters coping with them, surprise you?

  • How realistic is Rose's decision? What do you think will happen to her and Caleb at the end of the summer? What about five or 10 years from now?

Book details

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For kids who love romance and coming-of-age stories

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