The film is about a fictional Midwestern factory worker named Roy Applewood, who stuns his wife of 25 years by saying he wishes to undergo sex reassignment surgery and transition to a woman.

She also said that she wanted to use the play "as a metaphor for a study of marriage", calling transition the "ultimate betrayal".

[2] Roy Applewood (Tom Wilkinson), after fainting on the night of his 25th marriage anniversary, shocks his wife Irma (Jessica Lange) by revealing plans to transition into a woman named Ruth.

Patty Ann (Hayden Panettiere), their daughter, is more accepting, but Wayne (Joseph Sikora), their son, struggles with the transition.

Robert Pardi of TV Guide, reviewed the film and stated "Writer-director Jane Anderson tries to shoehorn her own play into the TV-tragedy", "but it's an awkward fit" and "Although the performances are superb, the film's detachment doesn't suit the bizarre material".

Jessica Lange and Tom Wilkinson both received acting nominations for the Golden Globe, Primetime Emmy, and Satellite Awards.