It was written in the 1980's, when the religious right was going on nonstop about the satanic panic conspiracy or trying to shut down/cancel anything it did not like much like troons and sjws are doing now.
This was also the time of political aftermath about improperly disposed of industrial and chemical wastes as seen with news stories like the whole Love Canal and Valley of the Drums controversies during the 1970's.
In the book, a religious extremist group does overthrow the US government and basically institutes a theocracy. The book is written from the point of view of a woman who is a Handmaiden called Offred, which are basically surrogate pregnancy breeders for the upper class members of society, as the theocracy felt that women had shirked their religious duty to bear children, and as decades of industrial pollution had caused widespread sterility in much of the US population, the theocracy felt that fertile women were too precious of a resource to waste.
A lot of people misconstrue the book as feminist propaganda, but the theocracy makes things shitty for both men and women, as the vast majority of the male population is forcibly conscripted into the military for the purposes of ongoing wars of imperialism, and many of the women taken to be handmaidens mourn the fact that they have had their former spouses and existing children forcibly taken away from them.
In a way, the troons we talk about here and elsewhere remind me of the theocracy in charge of the Republic of Gilead, as they both tolerate no dissent and want to forcibly impose a rigid and tyrannical ideology on society.