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“Love. Marriage. Acceptance. Sex change.”

After twenty-five years of marriage, Roy Applewood (Tom Wilkinson), a Midwestern factory worker, tells his wife Irma (Jessica Lange) that he intends to have a sex change operation and live as Ruth. Jane Anderson adapted her own play and keeps the story close to the farmhouse kitchen and the town's churchgoing neighbors. Irma and their daughter Patty Ann (Hayden Panettiere) have to decide whether the family they have can hold together.