Ava Moore used to identify as a gay man who worked as a professional escort to wealthy older women. Avery was in love with Dr. Barrett Moore (Alec Baldwin), and used his charisma to convince his wealthy female dates to finance Moore's medical research.
However, to Ava's growing disappointment, Barrett Moore was a confirmed heterosexual and refused to advance his friendship with Ava to a romantic relationship. Ava fell into a deep depression and, determined to have Moore's love at any cost, asked the doctor to perform sex reassignment surgery on her. Intrigued, Moore agreed and personally undertook the mission of transforming her "male body" into Ava. Moore's skill as a surgeon allowed him to turn Ava into what Christian Troy would later describe as "The Hope Diamond of transsexuals; completely flawless in every way." Ava was happy with her new form and the two married. But problems quickly popped up, as Moore could never truly accept Ava as being a woman and instead treated her like his prized creation. Ava sank further and further into depression. Moore arranged for one of his female employees to become pregnant with his child so Ava could become a mother and hopefully pull the three together as a family.
Ava grew increasingly distant from her husband and ultimately took their child and left in the middle of the night — right before the final surgery was to be performed to make her vagina deep enough to pass as biologically natural. She then began taking young lovers, since Ava believed that younger, sexually inexperienced boys would not be able to tell that her genitals were different from those of most women.
Seems like a lot of drama, but Famke is hot.