Ain't love grand? It is for Naomi, who is rapturously in love with Addison's brother Archer.
While relaxing on the beach in the moonlight, Addison listens to her best friend gush about how wonderful Archer really is. But when the wine runs out and Addison goes inside to get some more, she catches her brother making out with some floozy he's just brought home.
Addison hustles the floozy out the door, and then has to turn her head when Naomi comes into the house to smooch all over Archer. She doesn't have to look long. She gets an emergency call from Dell and makes a mad dash for Oceanside. She isn't going to tell Naomi? Isn't that wrong?
Anyway, Dell is delivering a baby. It's going well, but he's just nervous about flying solo. Addison takes over and in no time Carol, the mother, pushes the baby out. The new mom and dad, Mitch, are excited to see their new baby boy. Except, well, Addison can't figure out what sex the newborn actually is. Say what??
After consulting with Naomi, Addison determines that the baby is genetically a female, but extra testosterone has given it male and female genitalia. Since statistics show that only of children born with this condition identify as male, Naomi suggests removing the tiny penis so the parents can raise the child as a girl. But, Addison argues the decision should be made by the child when it becomes older.
The discussion about the baby is ended when Archer interrupts the meeting and begins making out with Naomi. We're grossed out. So is Addison, who runs out in horror.
Meanwhile, Charlotte asks Cooper to move in with her to try to make their relationship work. But Cooper refuses to move out on Violet during her pregnancy. Yep, they're at a stalemate again. Charlotte runs out on him in a huff.
When Mitch and Carol hear all their options, they ask Addison to perform surgery to make their baby a boy, which is what they were expecting to begin with. Addison is oddly compliant. She agrees to do what the parents want without hesitation.
With that decision made, Addison goes to see her brother in his office. She doesn't bother knocking and just barges in to witness what has to be the crime of the century: Archer and Charlotte putting their clothes back on after having sex! Absolutely gross. Both women run out on him: Addison in shock and Charlotte in tears.
The next day, Addison is in the operating room to perform the sex removal surgery. She's all ready to go when Naomi comes in to assist. But when Naomi starts gushing all over again about Archer-they're even going to go on vacation together!-Addison yells, "I can't do this" and storms out.
Addison tells the disappointed parents she can't go through with the surgery, that this should really be the child's decision when it's older. Mitch can't believe it. He wonders, "What will it be like for a six-year-old boy with a vagina?" Addison retorts, "Imagine being a 20-year-old woman without one." Mitch can't handle the situation and leaves his wife in the lurch.
Naomi asks Addison just what the hell is going on. Addison finally breaks down and confesses: Archer is cheating on her. Naomi runs away to find that Archer has vacated his office. Charlotte tells her that he's gone. Then, at home, Archer is all packed up. He's moving back to New York. Addison begs him not to run out without talking to Naomi, but he just leaves.
In a rage, Naomi tracks Mitch down at his job as a waiter. Right there in the restaurant in front of customers and co-workers, she yells at him for ditching his wife and baby. They need him, so he needs to step up and be a man for them.
Charlotte then confesses to Cooper that she slept with Archer. But rather than ending their relationship, Cooper proves his commitment to her by promising to not walk away from her even though she did this horrible thing. She better not do it again, but, for now, he's sticking with her. Charlotte bawls and falls into his arms.
Finally, Mitch returns to Oceanside to be reunited with-and to take care of-his family.