As Naomi and Archer grow closer as a couple, Addison suspects that her brother may have returned to his old, bachelor ways. Meanwhile, Dell, Addison and Naomi heatedly debate the pros and cons of gender reassignment surgery when their patients' newborn child is born with both male and female sex organs, and Violet and Sheldon settle some of their own issues when they co-lead a couples' therapy group.

After Addison discovers that a mentally unbalanced pregnant patient has lost her baby, Violet must convince her that the baby has died and that surgery is necessary, while Cooper must tell a longtime patient he must remove part of his jaw due to a fast-growing cancer. Meanwhile, Dell copes with the absence of his daughter after his ex moves for a new job, and Sam and Addison find themselves suppressing their feelings for two very unattainable people.