Alex gets a patient who works for Max who is in transition from male to female. And she discovers she has a condition that needs treatment but she's hesitant to do so. And when Pierce raises the question of him and Alex having children together, she says not likely. And Jesse meets a tattoo artist and asks if she can redo a tattoo he has. And when Alex learns of this, and sees it, and when she doesn't react to it, Jesse is hurt because it has ties to her.