The book was adapted as an opera of the same name, composed by Jake Heggie with a libretto by playwright Terrence McNally. It premiered at the San Francisco Opera in October 2000. The international premiere of the opera was in August 2003, in Adelaide. It has been produced in several other cities, including by the Union Avenue Opera in St. Louis, Missouri. In November 2019, Lyric Opera of Chicago presented their premiere of the opera. It premiered at the Metropolitan Opera in September 2023.