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I'm not sure I saw the same Transamerica as this reviewer did. I thought the performances of both leads were quite good. And the only people who really seem to have a porblem with Bree are the people in her own family, especially her mother who is a bit of a characiture. But almost everyone else in the film, no matter where they happen to be living, accept Bree as a woman. They even meet a group of transexuals in Dallas of all places in one of the important scenes in the film.
And a minor point, the boy grew up in Kentucky, not Oklahoma. It's little facts like that that lead me to believe the reviewer wasn't really paying attention.
The only problem I had was with the improbably resolution to the main conflict in the story. Otherwise I found this to be a delightful and interesting film that is definitely worth seeing.