The following edition of the text was used in the creation of this study guide: Khong, Rachel. Real Americans. Penguin Random House, 2024. Kindle AZW file.

The prologue takes place in Beijing, 1966. A man and a woman steal historical artifacts, including a lotus seed said to grant an emperor's greatest wish, fearing their destruction by the Red Guard.

In Part One, the story shifts to New York in 1999, narrated by Lily, a recent Chinese-American college graduate. She experiences strange episodes where time seems to stop. At her company’s holiday party, Lily meets Matthew, who gives her his raffle prize, a TV. They exchange numbers and later have dinner, followed by an impulsive trip to Paris, where they begin a romantic relationship. Matthew supports her financially, encouraging her to quit her job and move in with him, though Lily worries about disappointing her mother by relying on him. Lily loses her job and moves in with Matthew who tells her she doesn’t need to pay any rent. Lily becomes more aware of Matthew’s wealth when she meets his powerful family, who own a major pharmaceutical firm. Matthew proposes and they marry.

Lily and Matthew try to start a family but face miscarriages, leading them to pursue IVF which results in pregnancy. While visiting Beijing, Lily learns from an old friend of her mother, Peng, about Mae’s past during the Cultural Revolution and a mysterious lotus seed. Peng gives Lily a note for Mae, raising questions about her mother’s past. Back in New York, Mae arrives to help with Lily’s newborn son, Nico. Mae’s connection to Matthew’s father, Otto, is revealed when Lily overhears them talking. Suspicious of her mother’s past, Lily investigates and finds documents linking Mae to Otto’s family. This discovery leads Lily to contemplate cutting ties with both families, but she ultimately decides not to reveal what she found to Matthew. The reader does not discover the secret at this stage.

Part Two takes place in in 2021 and is told from the perspective of Nick, Lily's high school senior son, who lives with her on a small island near Seattle. Nick is curious about his absent father, Matthew, especially after his friend Timothy encourages him to learn more. Despite his mother's vague explanations, Nick takes a DNA test, revealing he is half-Chinese, despite the fact he does not look Asian. After Timothy contacts Matthew through a DNA website, Matthew reaches out to Nick. They begin emailing, and Matthew eventually visits, confirming his paternity due to their striking resemblance. Matthew begins giving Nick gifts and financial support, including a credit card in the name of "Nico Maier" (Matthew’s surname) urging Nick to use his last name to avoid anti-Asian bias in college applications. Nick applies to several prestigious universities and is accepted to all, just like Timothy. The boys set off to visit the campuses, using fake IDs with Nick posing as "Nico Maier." During the trip, Nick experiences the sensation of time stopping and finds an old online post describing the same phenomenon.

In New York, Matthew fails to show up as planned, later explaining it was due to his other son Samuel's overdose. Despite this, Matthew offers to pay for Nick's college. Nick decides to attend Yale, and Timothy changes his preference to Yale as well to stay close to Nick.

Nick starts at Yale with Timothy but feels out of place, believing he was accepted due to the Maeir family's influence. He struggles academically and with sleeplessness caused by the sensation of time stopping. After sharing this with his mother, Lily, she reveals she experiences the same phenomenon and teaches him how to use it, helping Nick excel in his studies.

Nick reconnects with Matthew in New York, where Matthew reveals that genetic experiments were conducted on both Lily and Nick by Lily’s mother Mae and Matthew’s father Otto. The experiments made Nick's DNA overwhelmingly similar to Matthew's, which explains why he doesn’t resemble Lily. This revelation leads to tension between Nick and Lily because Nick is angry Lily kept this from him. Nick chooses to spend Christmas with Matthew, who introduces him to his extended family, including Otto and. Nick starts an internship at the Maeir Foundation, working alongside his half-brother Sam, who resents how proud Matthew is of the more academically gifted and hardworking Nick. After a tense interaction, Sam overdoses, and Matthew coldly declines to accompany him to the hospital.

Part Three takes place in 2030 and is told from the perspective of Mae, Lily's mother, who now lives in San Francisco. Mae secretly follows her grandson Nick, observing his life but never revealing her identity. One day, Nick approaches Mae, recognizing her from an old photograph. Mae invites him in and begins to recount her life story.

Mae recalls her upbringing in rural China during Chairman Mao’s Great Leap Forward (1958), her family's hardships, and her early ambitions. She excelled in school and won a place to study biology at Peking University, where she met and fell in love with Ping. However, as political turmoil swept China, their lives were disrupted. The Red Guard's brutality and cultural destruction impacted Mae deeply. She and Ping dreamed of escaping to America, but when the time came, Mae chose to escape with Wen, who offered a safer route to Hong Kong, leaving Ping behind. Mae and Wen start a new life in Hong Kong. They eventually marry and move to America, where they work in a lab under Chinese immigrant Yang. Mae excels in learning English and both secure jobs under new owners, one of who is Otto Maeir, Matthew’s father.

In America, Mae and Wen, who has changed his name to Charles, celebrate Mao's death. Mae becomes pregnant, and they have a daughter, Lily. Mae discovers a way to alter genetic inheritance, which they test on Otto’s son Thomas and Lily, but the experiment leads to tragic consequences when Thomas commits suicide. Mae later realizes Lily’s infertility was caused the experiment. She and Otto decide to conduct the experiment again while Lily undergoes IVF, leading to Nick’s conception.

In the present day, Mae confesses to Nick about her past and regrets, asking him to reconnect her with Lily. Nick, working at a medical tech start-up, meets with a potential investor—his father Matthew—who supports his work on gene-editing technology. However, Nick becomes uneasy about the ethical implications after overhearing racist and unethical conversations about the potential uses of the new technology. Nick asks Matthew to buyout the company and immediately dissolve it in order to prevent the progress of potentially unethical scientific discoveries. The novel ends with Lily arriving at Mae’s apartment just before she dies.