Ava could not live with the pain, so she left with Adrian when Barrett was not home.

Since they could not conceive, Barrett used a surrogate, and Adrian was born. They married, but their marriage was not perfect. He perfected his plan for surgery, and made Avery a woman. Avery was a homosexual admirer of his, but Barrett could not love him the way Avery wanted him to. They learn that Ava's surgeon was a retired doctor by the name of Barrett Moore. Julia, Sean, and Christian spend the night researching, and trace their way to Maryland and a Gender Reassignment center. Christian goes to have a talk with Ava, and when trying to make a point using sex, he learns that Ava is really a transsexual.

Christian finds him, and gets upset when he learns Matt is going to Paris. Matt goes to McNamara-Troy to steal drugs for her to take with them. He suggests they go away to Paris and start a new life together, which she reluctantly accepts after some convincing. Matt is concerned about Ava, who seems obviously depressed. When she ultimately learns what she will turn out like after the work has been finished, she decides to give up on her original plan and asks the doctors to schedule her for a facelift the next morning. Joan Rivers consults with Sean and Christian to have all of her plastic surgeries undone, because she wants her grandson Cooper to learn that you don't have to be perfect. #3 - Joan Rivers Season 2 - Episode 16 - Aired

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