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Maria is a middle-aged single woman with three children. Saman is a newly married young man. Arash is an eighteen-year-old high-school dropout. The one thing they have in common is that all three are transsexuals living in the Islamic Republic of Iran.

INSIDE OUT features intimate conversations with Maria (a male-to-female transsexual), Saman (female-to-male) and Arash (female-to-male), allowing them to tell their stories, including the lifelong struggle to come to terms with their gender dysphoria, how this mind/body conflict has affected their everyday behavior, and the impact of hormone therapy and sex-change surgery on their lives.

The film also includes revealing interviews with a Muslim cleric, who explains that the majority of Iran's religious leaders consider transsexuality to be a human rights issue and therefore support gender reassignment surgery; a psychiatrist, who explains the difference between homosexuality and transsexuality and how the condition cannot be cured psychologically; and a surgeon, who discusses the nature and the difficulties of the required surgery.

INSIDE OUT also documents daily activities of the three individuals, showing how they are coming to terms with their new identities and the related emotional and physical transformations. These difficulties clearly pale compared to their former agony. As Maria, a 44-year-old father and former truck driver, states, 'Only a person who has felt this pain can understand it.' Thanks to this sensitive and insightful documentary, however, the rest of us can begin to understand the nature of this serious but still little-understood condition.