Tenderness features hard-minded, realistic presentation. Lori's unvarnished reve lations about herself and her sex life are but preludes to the harsher realities of the novel; her comments shock, like a slap on the arm before being given an injection.

What follows, the examination of the thoughts of a serial killer is appalling in its verisimilitude.

Tenderness has two narrative voices, one in the first person and limited to one character's point of view and the other in the third person, able to move from one character's thoughts to another's. The first-person narrator is Lori, who at one point notes that a favorite teacher had told her "that I had a talent for writing and should keep a journal." This is to explain her vivid, although disjointed, writing style. Her narrative slowly dovetails with the third-person narration until the two accounts breathlessly race along together.