Roy Applewood (Tom Wilkinson), after fainting on the night of his 25th anniversary, shocks his wife Irma (Jessica Lange) by revealing that he suffers from gender identity disorder and plans to transition into a woman and be renamed Ruth. While Roy tries to keep the family together, Irma's initial reaction is to separate from him. Patty Ann (Hayden Panettiere), their daughter, is more accepting, but Wayne (Joe Sikora), their son, struggles with his parent's transition. However, he comes to a new-found friendship and understanding with his family.
Roy faces ostracism at church and at work. He finds understanding from her boss but not from his minister.
In the end, Irma discovers that love transcends gender and the family survives.
