The album has been described by Anthony DeCurtis as "perhaps the most romantic album of Reed's career". Many of the album's songs were inspired by and dedicated to Reed's girlfriend and muse at the time, a trans woman named Rachel Humphreys.
According to Aidan Levy, Coney Island Baby was "as much a love letter to Rachel as it was to the nostalgic Coney Island of the mind."
The album's title track directly references Rachel with the line: "I'd like to send this one out to Lou and Rachel, and all the kids at P.S. 192.". "P.S. 192" refers to P.S. 192 – which at that time was a public school for kindergarten to 6th grade, in Brooklyn, New York City, where Reed went to school before moving to Long Island. In 1979 Reed said "Saying 'I'm a Coney Island baby' at the end of that song is like saying I haven't backed off an inch. And don't you forget it." It is a direct continuation of the poem "The Coach and Glory of Love" published in the Fall 1971 edition of The Harvard Advocate.
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|Lou and Rachel|
Lou Reed and John Cale, NY 1977 - Christmas