Annie and Mau revisit a traumatic birthday. Elaine calls DeSean twenty times a day and he's fed up. Sarah wants a baby, but Lauren isn't ready to be a mom because she just became a woman. Evelyn and Alan make a painful decision. Dr. Orna Guralnik wrestles with an overwhelming sense of responsibility she feels for her patients.

Mau needs sex every day. Back at the beginning of therapy, Evelyn feels betrayed by Alan and no longer trusts him. Orna has trouble remaining impartial. Elaine discovers a connection between her childhood trauma and her marriage.

A recent fight between Lauren and Sarah reveals underlying power dynamics. Orna pushes Mau and struggles with her inability to break through. DeSean is sick of failing to make Elaine happy.

Alan reveals the impact of his father's infidelity. Sarah wants Lauren to initiate sex. Mau's traumatic past casts a long shadow.

Elaine discovers the roots of her feeling that DeSean doesn't care about her. Lauren and Sarah make a pivotal decision about the future. Annie opens up about past sexual trauma and Mau loses his cool. Orna walks a tightrope.

Elaine and DeSean argue about the impact of racism on their marriage. Orna feels frustrated by the lack of progress. Sarah's doubts scare Lauren. Evelyn and Alan make an excruciating decision about their marriage.

Annie questions what they're fighting to hold on to. Lauren and Sarah are devastated, and Sarah can't shake the feeling she's being punished. Orna feels pressure to do more. DeSean is furious and Orna presses Elaine to face her past.

Sarah wants to feel precious, and Lauren investigates her own defensiveness. Elaine has a breakthrough while DeSean discovers his role in their struggle. Alan finally opens up and Evelyn is shocked. Annie states the brutal truth.

Lauren and Sarah make a choice about their future. Alan and Evelyn find a path forward. Elaine and DeSean feel a shift. Orna feels the weight of her work, and marvels at how bizarre her profession is.