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The Royal College of Psychiatrists Improving the lives of people with mental illness



Transamerica was released in 2006 and was written and directed by Duncan Tucker.  It is a road movie whose central character, Bree, played by Felicity Huffman, is a pre-operative male-to-female transsexual, awaiting final gender realignment surgery, who discovers that she has an unknown son called Toby.  His story forms an important part of the film too, portraying his search to find his father and his roots.

Felicity Huffman’s performance is outstanding and won her numerous awards, including the Golden Globe (2006) for Best Performance by an actress in a Motion Picture Drama, two International Gay and Lesbian Film Festival Awards for Best Feature Film (2005) as well as an Oscar nomination.



In an interview with Robert Newton in 2005, Duncan Tucker was asked what had prompted him to write the screenplay and he replied: “I was thinking about the themes of family and what it's like to feel like a misfit and not at home in your own skin. Anyone who has been to high school knows these themes. Everyone's journey in life is to grow up, and Bree thinks her journey will end when she becomes female, but realizes that hers is really a journey into womanhood, to a place where she can feel the pain and joy of life again.” He also explains that the portrayal of Bree’s mother was inspired by his experience of his own mother.


In the same interview, Tucker reveals that his story was inspired by a woman he knew in Los Angeles, who one day revealed her true identity to him as a male-to-female transsexual. This led him to research the topic extensively, meeting more than a dozen transsexual women, and reading everything he could on the subject. Tucker even considered using a male to female transgendered actress for the part of Bree, but as those known to him were living ‘stealth’ (passing as women without revealing their original biological sex) he felt it would be too difficult for them.

The Film

We meet Bree, formerly known as Stanley, at the start of the film practising the voice exercises that help her to sound more like a woman.  She then takes a phone call and states that “Stanley doesn’t live here anymore”, but learns from that call that Stanley has a son, called Toby, who is in trouble in New York.  Bree, unaware that she had ever fathered a child, mentions Toby to her therapist when she is about to hand over the paperwork allowing Bree to proceed with surgery.  Her therapist consequently suggests that she must find out more about her son before the surgery can proceed. Bree’s male biological identity, and her ability to have fathered a child, must be acknowledged and explored before it can be relinquished.


This sets the scene for the journey that follows as Bree, posing as a church worker, bails her son from jail and travels back across America to Los Angeles with him, only revealing various truths about herself to him at different stages along the way.  Toby’s search for a stable and positive relationship with his unknown father adds dramatic tension for viewers, who are in the privileged position of understanding just who Bree is to Toby before he discovers the truth. It is through Toby’s eyes that we are able to scrutinise Bree’s performance as a woman, such as when they befriend a man who gives them a ride part of the way, and who appears to fall for Bree, unaware of her history.  We watch as Toby struggles to see his father as a woman, to whom another man is attracted as a woman.

A reluctant visit to her family home provides some very painful scenes, as her mother states that she cannot respect Bree’s new identity and both parents express grief for the loss of their son Stanley.  However, even crueler is their delight in the discovery that they have a grandson, who somehow replaces their lost son. It is in this setting that Bree is forced into revealing her circumstances fully to Toby and to outline her plans for surgery.


Bree and Toby do finally end up in Los Angeles but the film resists a completely ‘Happy ever after’ ending. While Transamerica tells its story with humour, it does not trivialise any of the big issues at the core of the film.


Relevance to the field of Mental Health

The challenge for anyone working in the mental health field is always to elicit and understand what a person is thinking and feeling whilst recognising that this may be in contrast to their appearance and behaviour.  This is especially so in matters of gender identity (the gender that you feel you should be) and gender dysphoria (a condition that describes the feeling of being trapped in a body of the wrong sex). Transamerica offers the viewer the experience of just such an assessment, through the eyes of Toby, from his first encounter with Bree to the final scenes. The film raises an awareness of the psychological conflict an individual may experience if they decide to be open about their transsexuality and illustrates the courage that is required to make such a life choice. Bree, like many others had not chosen the path of openness, but is unexpectedly forced into revealing her history to Toby, giving us an empathic understanding of what it may be like to be ‘outed’ against one’s will.


Transamerica is a film about performance and the search for authenticity.  We watch, in some detail, the struggle of Bree as she tries to pass as a woman. At the same time, we are drawn to the work of the actress, Felicity Huffman, who must offer us a credible performance as a biological male before she can perform as a transitioning transsexual woman. The film encourages us to reflect upon the performance of gender stereotypical roles that we all learn at an early age and to consider how hard it might be to change those performances.


Transsexualism is an extreme and long-term type of gender dysphoria. It is defined in ICD-10 as a mental disorder of adult personality and behaviour (F64.0). For diagnosis, the individual must have a very strong desire to live as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, their anatomic sex and a wish to make his or her body as congruent as possible with the preferred sex (usually involving hormone treatment and surgery). It is also important that none of these feelings exist as a symptom of another mental disorder like schizophrenia or as a result of a genetic or chromosomal abnormality.


The NHS has good information available on its website on the subject of Gender Dysphoria, which has an estimated prevalence in the UK of 1 in 4,000 people who are receiving medical help, although there may be many more people with the condition who have yet to seek help. On average, men are diagnosed with gender dysphoria five times more often than women.


The subject of transsexualism is gaining wider general public awareness in the UK, through various openly transsexual individuals, such as supermodel Lea T who is the new face of Givenchy, and Juliet Jacques, who has been describing her personal transgender journey in a regular column in the Guardian newspaper as well as TV soap Hollyoaks, which is tackling the subject in a storyline about a teenager with gender dysphoria.


For anyone wanting to gain a greater empathic understanding of the enormously complex issues facing people who seek to realign their biological sex to match their gender identity, Transamerica is a perfect starting point.


Minds on Film blog is written by Dr J Almeida, Consultant Psychiatrist.                          

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About this blog


Minds on Film is a monthly blog that explores psychiatric conditions and mental health issues as portrayed in a selection of readily available films.

Please note that this blog may contain plot spoilers. Any views expressed are purely my own.

Dr Joyce Almeida
Dr Almeida is a consultant
psychiatrist working in the private sector in the UK.