Four trans women from New York City are interviewed in what is professed to be part of a six-month psychological project.

They discuss having to present as male during the day at their jobs, undergoing hormone therapy, their dating lives, and their childhood.

[14] Queens at Heart was screened at the Museum of Fine Arts, Boston in 2012 alongside two other films about early LGBT life: Mona's Candle Light (1950) and Choosing Children (1984).

[9] In 2019, the IFC Center in New York City played it alongside a restored version of the 1968 documentary The Queen.

[12] However, critics have also noted it provides a candid look at the life of some transgender women in the time before the Stonewall riots.

J. Hoberman for The New York Times called it "at once an exploitation film and an educational one, with a tone variously prurient, dismissive, and nonjudgemental".

called it "a red-blooded American exploitation film that tries to pass itself off as an expert documentary" and criticized the interviewer but also said the four women's participation "has enormous value for those interested in queer and trans life before Stonewall.