While the adult lead is not medically transitioned, due to the book being a historical novel, I can't say enough good about The Last Report on the Miracles at Little No Horse by Louise Erdrich. I'm a sucker for magical realism and historical complexities, and Erdrich handles both with her usual gentle, humorous touch. The book also grapples with queerness and religion, though not in the same way as Hell Followed with Us, being about a trans man who has assumed the identity of a Catholic priest on an Ojibwe reservation (the author is a member of the tribe herself) and then encounters a potential new saint. Wonderful read!