A trans man was cast as the voice actor for Tyler Ronan, of the two main characters, who had transitioned during his time away from his sister.

The developers consulted with expert groups for its themes, notably GLAAD, a non-governmental organization (NGO) monitoring media coverage of LGBT people, to ensure authentic and respectful portrayal of LGBT characters. Since it was announced in November 2019, the game has been noted for being the first AAA video game to feature a transgender person as a main character. A recurring theme of the story is the fallacy of memory, as the narrative explores the twins' childhood trauma and how they may each remember pivotal moments differently. It follows a pair of twins, Tyler and Alyson, with the ability to communicate with each other through telepathy, who reunite after ten years in their hometown in rural Alaska and investigate the death of their mother. The game consists of three chapters released for Windows and Xbox One in late 2020. Tell Me Why is an episodic adventure game developed by Dontnod Entertainment and published by Xbox Game Studios.

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