Another car pulls up, and the driver's- side door opens. A large bejeweled hand sets a Tupperware container of salad on the car's roof. The driver emerges. She is stunning, more than six-feet tall, with flowing hair and a soft summer skirt.

The air is gentle. The grass is green. The sky is blue. And JoAnne is just a big girl on her way to a little barbecue. Right as rain.

She walks carefully on low heels. She is a serene woman of a certain age. Her clothing drapes in a way that indicates quality. Her makeup is tasteful.

Karen and Bob open the door to a home befitting the Bradys or the Huxtables or the Romanos. Hugs and greetings ensue. Another person of a certain age hands JoAnne a nametag. His hair is longish and nicely coiffed. He is wearing casual slacks. And a casual floral blouse. And espadrille slides. And a nametag that says "Julie."

Everyone at this monthly meeting of TransFamily knows JoAnne.

She is a genetic man who spends part of her life "presenting" as a woman. Unlike some others, JoAnne does not take female hormones, nor has she altered her genetic male body to feminize herself. When she is not presenting as a woman, she is a husband and father and businessman.

Today, she is in good company.

The event is casual. More than 30 attendees chat as they nosh on hot dogs and burgers and potato salad. Dress is comfortable for most. Some are presenting as women, some are not. There is also a handful of female-to-male transgenders. During a trans-friendly event such as this, "passing" or "getting clocked" isn't an issue. The group represents all ages and professions. Many espouse religious beliefs.

They are mostly heterosexual, but all transgenders are quick to assert that gender issues are not related to sexual orientation — which others can find disorienting, especially in a group like this, where the usual distinctions between male and female are blurred in various ways. Who is a man and who is a woman? To what gender are they attracted? Casual conversation becomes challenging; what pronouns are appropriate?

For some, the transgender manifestation is subtle (a lacy undergarment under the rough work jumpsuit), or closeted (dressing after the kids go to bed and lounging around the house). Others undergo drastic sexual reassignment via hormone therapy and surgery. Coming out always has implications, and it's a common topic at TransFamily gatherings.

"My daughter told me she didn't want to talk to me or see me," says Rachel through a forkful of baked beans. "She told me that my newest granddaughter will never know me." Rachel wears Capri pants and speaks in an undisguised male voice.

"This is how they punish me," she adds, adding that she is hopeful that one day her children will "come around" and learn to accept her. "Took me 50 years to come to terms with it."

"My daughter says there's no such thing as transgender people," says Paul, who is not presenting today. He is well into his 70s. His wife, Joan, is by his side, diminutive and fragile. She adds, "She wrote us a long nasty letter, saying, "Daddy never showed any signs of this when I was growing up.'" Their daughter is in her 40s.

Pam is dressed in a pantsuit befitting any office. She is attractively made up, a bit more elaborately than most of the others. She could easily pass as Jean from accounting or your Aunt Sal.

"My girlfriend moved to Las Vegas," she says. "This is my first meeting. I'm hoping to make some new connections. Meet some people." She points her fork at the dollop of JoAnne's Asian rice salad on her plate. "My word, this is good." Using a paper napkin, she dabs at her lips gingerly. This face took some time to create.

First there is the shaving.

Your face, your legs, and, if you are going to be wearing a strapless gown, your chest and arms. No matter how meticulous you are about removing your beard and mustache, however, the issue of 5-o'clock shadow is problematic. You must put on enough of the right kind of make-up to disguise it, which is a tall order. You do not often present yourself as a woman during the day. Sunlight is unforgiving.

Clothing is another ordeal. Hiding evidence of the usual suspect is one thing, but what about hips? What sort of skirt is best suited for making a man's hips look feminine? Wigs and purses. Lipstick and falsies. Make-up takes at least 45 minutes and as long as three hours. Getting ready for a dressy event can take all day.

You have been married for 28 years. You were in the Navy for 15 years. You go to church. You ride a motorcycle. You are a Republican. You are a Democrat. You have three kids. You operate a tow motor. You manage a department. You've been a pallbearer.

If you are going to a transgender event, a drag-queen event, a queer event, a choose-your-label event, there is less pressure than if you are going to the Carousel Dinner Theatre or Arabica Coffeehouse or Parmatown Mall, where people will stare and snicker. Stepping into the ladies' room takes more balls than stepping into the men's room. Either move can get you into a fistfight. But the pay-off is that you are out and visible, presenting yourself as Allison or Jackie or Samantha.

The world treats Samantha differently than Sam.

Sometimes the world knows that Samantha is Sam in a dress and sometimes it does not. Regardless, being Samantha washes stress and tension from you. Being Samantha relaxes you and pushes Sam's difficulties away. Like his 19-year-old daughter's suicide.

When you are a man who wears a dress, you look out for other men in dresses. You stick together. You don't hesitate to leave your life behind and go to the aid of one of your sisters who is battling cancer and, having been abandoned by her family for wearing a dress, is alone.

You face the conundrum of coming out versus not coming out. On one hand, you know that if you do not have some portion of a woman's life, you will drown in a sea of alcohol and tears. If you come out, you might lose every outward thing that defines you, your job and your family and your friends. Cable installers named Jack are not allowed to wear dresses.

You really love women.

You love them and their stuff. You love to look at them and touch them and taste them and make love to them. You study them. You are jealous of their beauty and their skin, their baubles and eye shadow.

When you are a man in a dress, you idolize women.

You apologize to your wife about having to give some portion of yourself up to the woman you are profoundly compelled to be and hope she is sympathetic. At least tolerant.

You'll take all the acceptance you can get.

JoAnne's Asian rice salad is all but gone. The scoop left at the bottom of the Tupperware remains only because everyone is too polite to take it.

The group shuffles about clearing paper plates and plastic silverware. They arrange the lawn chairs into a large circle. In any other yard, one would expect a bonfire and roasted marshmallows to be the next order of business. But instead, the TransFamily of Cleveland meeting begins in earnest. Moderator Karen invites each attendee to speak in turn. Nearly everyone has something to say.

Some of the comments elicit laughter.

"It's kind of hard being a Latino trannie boy in Ohio."

"Hello. My name is Foster Brooks and I'm a trans-aholic."

Some garner applause.

"I'm going for my PhD in physics."

"The V.A. approved my disability."

Phyllis takes her turn. Wearing a T-shirt and jeans, she is in her mid-20s and has been out for about a year. Her wife will no longer talk with her. "I'm dealing with the loss of my family," she says, adding that her mother is succumbing to cancer. "My dying mother doesn't want me on her death bed. She's still my mother and I love her." Furthermore, her father does not want her around when she is presenting as Phyllis. "My uncle doesn't want me around his kids," she adds, and the group falls quiet.

"Never give up," advises Karen.

"You never know when they'll come around," offers yet another.

Heads nod in understanding. The collective desire for acceptance is palpable.

Phyllis relinquishes the floor to Chris, who introduces herself as Phyllis's girlfriend.

"It seems like trans is contagious or something," says Chris, saying that since she's been seeing Phyllis, she's been interested in exploring living as a boy. "I'm her boyfriend and I like that in the context of the relationship."

Next up is Loni, who wears a beautifully embroidered scarf around her neck. "Tell us about the scarf, Loni," asks Karen.

"Isn't it beautiful?" responds Loni, displaying it for the group.

"Yes it is," says Karen. "But tell us where it came from."

"Thailand," says Loni sheepishly. "I took a little trip earlier this year and had my SRS."

Changing a male body into a female body is a difficult task.

The first step is hormone therapy. Estrogen treatments and androgen blockers aid in fat redistribution, change the complexion, eventually reduce body hair, sex drive.

For those male-to-female transsexuals like Loni who choose a more drastic sexual transformation, sexual reassignment surgery (SRS), or vaginoplasty, is the next option. The penis is cut open and the majority of the erectile tissue is removed, save a small amount that will serve as the new clitoris. The skin of the penis is left intact. This empty sleeve is constructed into a neo-vaginal cavity. The flesh is sewn together and inverted, then placed into the abdomen of the patient.

The human body is resistant to forced change, however, and will not accept the new cavity without persistent training with vaginal stents, which are basically clinical dildos. Post-operative patients insert the stents several times a day for periods of about a half-hour. The stents come in sets of five with gradually increasing diameters, the maximum of which is 1 1/2 inch. They must be inserted to a depth of four to six inches in order to ready the cavity for heterosexual intercourse.

There are few reputable surgeons performing sexual reassignments in North America. Most surgeries are done in Thailand where, even with travel expenses, the cost is less than it is stateside.

The postoperative stent training is mandatory for months after surgery. Those women who do not become sexually active must continue maintenance of the cavity throughout their lives.

Surgical complications include infection or a compromised urethra, and the formation of a fistula, or abnormal opening, between the neovagina and rectal wall, after which additional surgery to complete the reassignment will be required.

Some transsexuals opt for orchiectomy instead of SRS. The procedure involves the removal of both gonads and is more commonly referred to as castration.

Next a particularly regal woman, perhaps in her late 50s or early 60s, tells the TransFamily group she has just recently begun to present as Loretta. She clutches a straw purse and wears a short-sleeved cotton blouse and strappy sandals.

"I was divorced and retired," says Loretta. "I had nothing to look forward to but death. Retired people always do what they always wanted to do. I always wanted to dress. I'm just going through my end-of-life crisis."

The group claps and Loretta passes to Linda who says, "And it's cheaper than buying a 50-foot motorboat."

When the laughter subsides, Linda continues. "I don't have much to say tonight. Just that I've agreed to be the executor on my friend's estate. Her only son does not know she presents as a woman and there are people she'd like to take care of in the community." (Everyone here understands that Linda refers to the trans community.) "I've promised her that her son would never find out she dressed. And I meant it. Girls like us have to stick together."

The comment is met with murmurs of agreement.

George announces that he has finally scheduled an elective double mastectomy. "The girls' days are numbered," he says to more applause.

There are just a few more members yet to speak. Barb talks about her involvement with another transgender group. "We are working with the mother of a 9-year-old M-to-F girl who is transitioning," which also garners the response, "God bless those parents," as well as emphatic clapping.

"Things are getting better out there, people," she says as the day fades into a deeper shade of dusk.

For the girls who want to get out there after dark, a good place to start is Warren, Ohio.

That a town such as Warren, which lives in the ruts the steel industry left behind as it receded, is home to the Queen of Hearts Bar, is no small irony. Warren is neither rural nor urban nor suburban. It is the land of James Traficant (yes, still) and Fat Cats Tattoos (to name just one). There are boarded-up factories, dilapidated houses and acres of vacant weedy lots. There is Pete's Gun Shack (doing a brisk business) and the Tokyo Health Spa (nary a car in sight, but the neon sign promises that they are indeed open).

But if it is the third Saturday of the month, Warren is a place fit for a Queen.

The lot fills with cars. They venture from all points across Ohio and Pennsylvania and Indiana and Illinois. The chariots hark from Michigan and West Virginia and Missouri and New York. There is a baby-blue BMW Z3 Roadster next to an experienced Dodge Caravan, which is next to a gleaming Lexus sedan, which is next to a rusty Ford pick-up.

Inside, the bar is cavernous, with cinderblock walls, 20-foot ceilings and glittering disco balls. Forgiving red lights illuminate the bar, which is teeming. Cigarette smoke hangs. A bucket of beer (five longnecks on ice) can be had for $7 until 9 p.m., at which time the price goes to $10.

Shakira blares through the sound system as a man in a golf shirt and Dockers eyes a drop-dead gorgeous leggy thing in fishnets and thigh-highs.

"Y. M. C. A."

A man with a thick muscular neck slugs a Budweiser and wears a baby-doll dress.

Madonna.

Mini-dresses and five-inch heels (size 11 please). Long blond wigs and razor stubble. Lipstick and cigars.

"Dancing Queen."

Denise is a giggly blonde. She is wearing a pink tee, short shorts and the high-heeled ankle-tie slides that are so popular this season. Her toenails are expertly painted. She sips a Coors Light and chats with her date, an ordinary-looking man who strokes her back and neck. Now in her early 40s, she has been cross-dressing since she was 14 when she discovered the sensual side of pantyhose.

"I've been coming to the Queen for years," she says.

Although she is currently separated, Denise has been married for 22 years and has two children in their teens. "I miss my wife," she says. "I cried and cried for the first two months [of separation]. My wife never wants to go out with me. I wanted her to see that I could be myself. I still love my wife. She loved the person that I am. What makes me tick inside is still me. I still treat her like a goddess. I've spent my entire life idolizing women. That's how I've become the woman I am."

Reconciliation for Denise and her wife is not likely, however. Denise has been taking female hormones for three-and-a-half years and is scheduled to have a sex change operation in two months. She will travel to Thailand and stay for 29 days. The operation will cost her $13,000. Add travel expenses and the price surmounts $15,000.

Denise holds no trepidation concerning the delicate procedure; her penis is "that old part of me" that she does not like. "I've always hated intercourse," she says. Should she experience any dissatisfaction with the surgery after leaving Thailand, Denise may return to her surgeon and, unless she has had additional work by another surgeon, he will address her concerns without charge.

"My vagina comes with a lifetime warranty," says Denise.

Despite the fact that her date is a man, Denise is resolute in her love of women and considers herself a lesbian. "Most guys are pigs," she says. "I can't be any other way than honest and truthful," says Denise. "This is basically who I am. I love being a woman."

TransFamily of Cleveland (transfamily.org) is "a group for the support of transgendered and transsexual people, their parents, partners, children, other family members, friends and supportive others." The group meets once a month in a private home for a potluck barbecue and an open round-robin discussion. TransFamily boasts seven online e-mail discussion groups with participants from all over the world.

"If you are unsupportive, you are history," says TransFamily founder Bob, whose child, now grown, is transgender. He recalls the "flame war" e-mails the group fielded during its early days. "We weren't going to tolerate that."

There are two organizations in Northeast Ohio that cater specifically to men who love being women.

The Alpha Omega Society (aosoc.org) "is the support organization for heterosexual cross-dressers, their families and friends." Cleveland Life Enfemme (triess-cle.org) provides "social support and outreach focusing on heterosexual cross- dressers, their significant others, families and friends." Both organizations are careful about new members and who they allow to attend meetings.

This is a very cautious group of people.

Many of the cross-dressers interviewed for this article did so under the condition of strict anonymity. Although every assertion made in these pages is based on a transgendered person living in Northeast Ohio, the details have been blurred in order to mask identities. Their concerns included losing their jobs, or being turned away by their families and spouses. Some fear physical harm; most fear ridicule.

"We are the ostracized of the ostracized of the ostracized of the ostracized," says Rose, a 20-something college student.

And suppressing the need to present as a woman works for only so long.

"It was eating me alive," says Angie.

"I was dying inside, absolutely dying," adds Becky.

"Nobody was happy with me," says Jan. "I wasn't happy with myself."

Coming out often has consequences. Wanda's father instructed her to "never do that again" when she showed up for Thanksgiving dinner in a dress. She opted to out herself to her three daughters, all of whom are under 10, on Halloween when she said to them in full dress, "I like to dress like this at other times, too. It's all right. I just enjoy wearing women's clothing."

Shawna's wife was relieved.

"She thought I had met someone else," says Shawna. "I said to her, "Who else would have me?' My wife and family always come first."

JoAnne has been married for nearly 20 years. She has fathered three children. She is deeply entrenched in the transgender community and presents herself as a woman with her supper club and at her church.

"It's a different way of being me," she says of her life as a woman. "I have a very full life with the people in my church. I have the people in my supper club. I have a part of the life I might have led as a woman."

She pauses then adds, "Some of this is outside what I understand."