McConaughey, pared down to nothing but grit and sinew, gives the most recent in a series of performances of sensitivity and scope that show how wrong Hollywood was to relegate him to forgettable romantic comedies.  And the immensely gifted Jared Leto, always seemingly on the brink of a breakthrough since his days on “My So-Called Life,” is heartbreaking as Rayon, a trans woman who begins first a business relationship, then a friendship with Ron and finally becomes his family.  There’s no winking at the audience, not a hint of “look how brave I am to be dressing in women’s clothes.”  Leto, who lost a lot of weight and removed all of his body hair, did more than transform himself for the role.  He stayed in character throughout the shoot.  It is a reflection of his achievement in transforming himself into a character who was also transforming that one of the film’s most jarring images is when Rayon has to dress in a man’s business suit.  It is understated but devastatingly clear that for Rayon, men’s attire is cross-dressing.  We see how lost Rayon is, how far from herself, and how great a sacrifice she is willing to make to help the members of the Dallas Buyer’s Club.  Rayon is no saint, but Leto gives her dignity and grace and he shows us why Woodroof and Jennifer Garner’s beatific doctor would be so devoted to her.

For Woodroof, the scene that shows how far he has come is when Rayon is insulted by one of the men from his rodeo days.  As frail as he is, Woodroof can still put the guy in a headlock to insist on an apology, knowing that this means he can never go back to his old friends.  But it is just a recognition of what he has already known.  His diagnosis has moved him to another country, and one in which he found the shared retrovirus is a stronger bond than any he had ever made before.

The film wisely makes it clear that the symptoms of a fatal disease do not include a complete personality transformation; indeed, it is the qualities that got Woodroof into trouble that are the keys to his success in finding a way around the rules.  More important, with nothing left to lose, Woodroof finds for the first time that he has something to give.

Parents should know that this movie includes constant very strong language, explicit sexual references and situations with nudity, drinking, smoking, and drug use, themes of fatal illness and sad deaths, and some fighting and tense confrontations.

Family discussion: How does the diagnosis make Woodroof feel differently about his life?  What makes him change his mind about Rayon?

If you like this, try: the documentary, “How to Survive a Plague”