This book captures part of the therapy of the book's main character, Patrick Braden's. His therapist, Terence, suggested to Patrick that he write down everything on his mind in order to help others understand. Patrick Braden more accurately refers to the novel as The Life and Times of Patrick Braden.

Patrick Braden lives in the small Irish town of Tyreelin, on the South border of North and South Ireland. Braden, who lives with a foster family, enjoys wearing women's clothing and singing in front of the mirror. As he ages, his lust for feminine things increases.

Father Bernard, a priest, is Patrick's real father who raped Patrick's mother, Eily Bergin, when she was a teenage girl. As part of his therapy, Patrick writes many short stories about this incident.

After finishing high school, Patrick, who dresses like a woman, leaves town and is picked up by a man in a Mercedes. The man becomes Patrick's boyfriend, and supports him for several months. However, Mr. Teat, as Patrick calls him, is killed and Patrick returns to Tyreelin.

Patrick soon leaves for London where he becomes a prostitute in Piccadilly Circus. A client, whom Patrick calls Silky String, attempts to murder him, but Patrick escapes. He continues practicing prostitution on the streets of London. He eventually meets a man named Bert and moves in with him. Several months later, Patrick falls in love with Louise, Bert's landlady, and he leaves Bert to be with her. When Patrick confesses that he loves her because she reminds him of his mother, Louise breaks up with him.

Irwin, one of Patrick's childhood friends, is killed while participating with the Irish republican Army. Charlie, his lover and a friend of Patrick's, becomes distraught over Irwin's death.

Patrick goes dancing at a bar one evening. While dancing with an officer, a bomb explodes and kills everyone except Patrick. The police seem certain that it was Patrick who planted the bomb and they take him into custody. Patrick meets Terence, who begins reading his short stories. After seven days pass and no evidence turns up, the police release Patrick.

Patrick returns to Tyreelin and purchases a house and a dog for him and Charlie. Charlie recovers from her depression related to Irwin's death and gets married. Patrick, who lives his life as a woman, spends his days flipping through magazines and looking at pictures of women.