Shaun's new neighbor, Kenny, knocks on his balcony door and asks if he can run a cable line to Shaun's TV because the cable guy can't come until next week.
At the hospital, Dr. Morgan Reznick joins Melendez's team of interns because of Coyle's transfer. Dr. Lim selects Shaun and Jared to help her in a surgery competition to see who can have the highest patient satisfaction survey numbers. Melendez picks Dr. Browne and Reznick.
Quinn, a young girl in the ER, has a stomach ache that they believe is appendicitis. The doctors examine her and are shocked to learn that she has a penis. The grandmother that brought her to the hospital says it's a phase. Shaun says biologically she is a boy. Jared says she is a girl and has a gender that is different from her own.
Melendez's patient, Howard, passed out while teaching his class. He has taken a lot of medications for various reasons. The doctors ask who prescribed all of those medications. He said they were leftover in his medicine cabinet. He has severe stomach pain, a fever, and dehydration.
Marcus and his wife meet with a fertility specialist to see why they haven't gotten pregnant yet.
Claire does an ultrasound on her patient. His appendix has ruptured. They go to take him to emergency surgery, but he worries about who will take care of his kids. Reznick says Claire will make the calls to his kids while she preps him for surgery.
Shaun asks inappropriate questions to Quinn like "do you wear dresses?" and other gender-related questions. Jared tries to stop him.
In the OR, Melendez tells Drs. Browne and Reznick to close up on the patient and finish Howard's surgery. Claire tells Reznick that it's good to have another woman on the team. Reznick says they are not friends because they are competing with each other.
Jared tells Shaun to stop calling Quinn a "he." Shaun says transgender patient care was not part of his medical school. Quinn's test shows that she has testicular cancer.
The doctors tell Quinn and her grandmother about the cancer. The prognosis is good. Shaun says "he" also has low bone density. He continues to call her a "he" and Jared tells him to stop. Quinn is on puberty blockers, which caused the bone density. She didn't say anything sooner because she and her parents didn't want her grandmother to know.
Howard has an abscess. The man is worried about his kids. Dr. Resnick says he can look at this as a vacation from his kids. He says they're his whole life and he lost his wife to cervical cancer last year so he hates hospital. Claire says she'll find a laptop so he can Skype his kids and get a few teddy bears so he can take home gifts for them.
Quinn asks if she has to stop taking puberty blockers. The doctors say yes, but she doesn't want to go through puberty as a boy because they can't reverse that.
Howard starts to crash.
Quinn's parents have arrived. The doctors say Quinn is going to have a surgery to remove her cancerous testicle. Quinn is sad that she has to stop the puberty blockers. Shaun suggests they remove both testicles so that it stops puberty. Quinn's grandmother is upset about this and still refers to Quinn as her "grandson." Quinn wants to have the surgery Shaun recommends because she is going to have gender confirmation surgery at age 18 anyway.
Dr. Lim reprimands Shaun for what he said in front of the patient. Shaun and Jared are assigned to create a document that explains all of the options for Quinn's care.
Howard is not responding to antibiotics because he's taken too much medication for the wrong symptoms. Drs. Melendez and Reznick tell him that they have to attach a colostomy bag to him indefinitely.
Jared says he doesn't understand why Shaun recommended the surgery when he doesn't believe that Quinn is a girl. Jared says they're going to lose the competition. Shaun says it's not important, but it is to Jared because of his previous incident with Dr. Coyle.
Andrews is at home with his wife. There was an irregularity with one of the tests, but the fertility specialist wants to rerun the test to make sure. His wife, Isabel, blames herself for waiting too long to have a baby. Andrews says she had goals for her career. Andrews says he knew this was going to happen. His wife says he has been resenting her about this. Andrews says he doesn't resent her but can't say that it's not her fault.
Shaun is at home watching TV when Kenny neighbor comes in through the balcony door again. He sits down and asks Shaun what kind of doctor he is. Shaun turns the TV off and talks to him.
Dr. Glassman goes to talk to Quinn's parents. Quinn's grandmother has made a claim of child abuse against her parents for them validating Quinn's transgender status. Quinn's mother is scared that her mother won't let the abuse go. The parents tell the doctors to do the surgery that Quinn wants to put an end to the grandmother's abuse claim.
Marcus and his wife meet with the fertility doctor. The tests showed that he had a low sperm count and low sperm motility. Marcus is upset about this news.
Claire talks to Reznick. She is mad that Reznick didn't tell her about Howard's test results. Reznick says it doesn't matter because they won't win the competition. Claire says Reznick doesn't understand anything about patient care. Claire says they could do a fecal microbiotic transplant to help Howard. Reznick is interested because it means they could win the competition. Claire says she will pull all the research before talking to Melendez and leaves.
Glassman meets with Quinn's parents and grandmother to discuss patient care. Her parents says Quinn has always told them she was a girl. They say that when she went out in public, they made her go out as a boy. It made Quinn depressed and reclusive, causing her to attempt suicide. After that, they let her be who she is. The grandmother is shocked by this news.
Claire goes to Melendez at the cafeteria to present the fecal transplant idea. Reznick walks in on the meeting and talks to them as well. Melendez agrees and walks away. Reznick is excited and tells Claire that she got the stool they will use and that Claire is the designated person in charge of it. Claire is mad that Reznick is only a team player when it benefits her.
Shaun sits with Quinn. He asks what it's like to be a girl. Quinn explains how she felt when she looked like a boy. She explains that it felt like she was in a pool and was finally free and could float when she transitioned into a girl.
The parents ask if the bilateral surgery is more risky than the unilateral surgery. Andrews says they should do the unilateral surgery because she won't be able to have children in the future if they remove both testicles. Dr. Lim says they should do the bilateral surgery because of Quinn's previous suicide attempt. She says this surgery could help her.
Glassman tells them that they need to decide what is best for Quinn. The parents say Quinn will always be a girl. Glassman says he knows what it's like to not put his family first and that it cost him a great deal when he didn't. He and the other doctors leave them alone to talk about their options.
Quinn starts screaming in pain and vomiting. The tumor caused a testicular torsion and she needs emergency surgery.
Andrews runs into the room where Quinn's parents and grandmother are talking and says they need to operate right away. The parents say to only do what is medically necessary. Andrews goes to operate.
Quinn has complications in the surgery, but they can't find a bleed.
Claire does Howard's procedure. Claire says she was thinking about writing up the procedure and publishing. Reznick offers to help her before since she has been published. Melendez says her previous paper was great and tells Claire she should read it.
Jared finds a bruise on Quinn's stomach that can mean she has internal bleeding. The doctors begin cutting her stomach and find that she was internally bleeding.
Howard is going to be okay. He asks when he can have visitors, and Reznick says he thought he might ask that so she had his kids come to the hospital.
Quinn wakes up after surgery and asks if they removed both testicles. The parents tell her they removed just the cancerous one. Marcus takes the blame at first, but the parents tell her it was their decision. They tell her that she can start feminizing hormones soon, under the guidance of an endocrinologist. Marcus tells her she may want kids someday. Quinn tells Andrews that if she wants kids, she can just adopt. She says she will be back when she's 18 for her gender confirmation surgery. Her grandmother comes in to bring Quinn flowers. Shaun tells her grandmother that Quinn doesn't like pink, she is a purple girl. It is the first time Shaun refers to her as a girl.
Melendez tells Claire that she needs to rise up and play against Resnick. He tells her not to wait for it.
Glassman goes to Shaun and congratulates Shaun on saving Quinn's life. Shaun says he likes her but he has lots of questions. Glassman says that's good because it brings about understanding and maybe even acceptance. He says being a kid is tough enough but being a trans kid is even harder. He offers to take Shaun to get some food and to go home. Shaun says no because Glassman said he can't be Shaun's friend.
Shaun goes to his neighbor and says he needs help. The neighbor agrees to help him go to the pool and learn how to float so that he can understand what Quinn was talking about.