I'm not entirely sure when the story is set. You are told that it's set after an apocalyptic event sent by God to cleanse the land and the people of their high self-esteem called Tribulation. Some think it's set in the future, but David - the main character - seemed pretty awe-struck when he sees the technology the the S/Zealand people have (much like what we have today).
Anyway, as a young boy David has the idea rammed down his throat from every side that if you do not have ten fingers, ten toes, two arms, two legs, etc., you are not in the true image of God. You must be destroyed to prevent the spread of your type. If you're a crop that's bad - a deviation - you'll be burnt. If you're a human with something 'abnormal' - a blasphemy - you'll be sterilised and banished to the Fringes where other 'different' people are. It's when David meets a young girl around his age that the stirrings of doubt start. Sophie has six toes on each foot, yet she's still pleasant, brave, and great fun. Unfortunately, and to David's dismay too, the same fate befalls Sophie as many other blasphemies before her.
Little by little, the reader begins to learn that David and a sibling are both blasphemies too - but not physically. Essentially, they and 8 others are telepathic, and towards the end you find out that there's a whole land where being telepathic is the norm, and you are to be pitied if you are not. The whole book is questioning David's father's (and many others') enforcement of this one true image and is a great story as well. The book was shocking, surprising and sad and I give it a no-brainer 5/5 stars.