There are wall mounted duct-pipe and ductless air conditioners. They aren't as efficient, but they work. They are the most common A/C units I've seen here in Mexico.
So if you don't have A/C, it's certainly not because you physically can't. I personally get by with a fan.
Though I definitely have culture shock when I return to Texas and remember people will have their A/C on 24/7 at 69F.
I live in Seattle and I finally broke down and bought a window unit but my windows open horizontally (Honeywell MN10CESWW), the unit I got is actually floor one with rollers so I can stow it in a closet when not in use, and it has a duct that connects to a vertical thing that goes in the window. I never thought I would need one, I have lived here my whole life but now we have 3 or 4 weeks a year where it is just unbearable so I use it to cool my bedroom. Just Crazy.
