How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!
Dear How to Do It,
Several months ago, during a rough patch in my relationship, I finally got the nerve to tell my partner that I have always hated performing oral sex and that it hurts my jaw to do so. That made things even worse—threats of separation came flying. I was told that they will not go forever without it, and that I needed to figure it out. Under threat of separation, I said I’d do it once a month. Despite my partner knowing how I feel, they predictably beg for it at the beginning of every month. I’m having a hard time not getting angry and resentful that they have no problem making me feel like I have to do something I hate. If I say no, I get the silent treatment with the occasional begging for it until I give in. Afterward, I’m pissed at them for making me feel like I have no choice and myself for doing something I know I don’t want to do. Every time they beg, I try offering sex instead, which they turn down. What do I do here?
Imagine a future in which this pressure, conflict, coercion, and resentment is just the way things are. Without any effort to change things on either side, that’s what you’re looking at. Is this worth putting up with? Sounds shitty to me! Partly as a tactic and partly out of curiosity, I would ignore them the next time your partner throws their grown-up temper tantrum. Try not giving in and see where that gets you. Just don’t do that thing you hate. In theory, I understand where your partner is coming from—oral sex is great, and I too would have a hard time imagining life without it. But your firm no overrides their entitlement.
Is opening the relationship so that they can get the oral sex they crave an option? If not, you may be looking at even harder choices. Many people feel self-conscious about ending a relationship over sex; we regularly hear from letter writers who think it would seem superficial or silly to do so. Your letter illustrates how what might appear initially as an issue concerning sex actually has many ramifications. The primary one, as I see it, is you and your body are not being respected. If a partner is comfortable treating you that way over sex, I’d bet that they’re comfortable treating you that way in other contexts. That’s not the kind of situation I’d want to be in. If nothing changes, will you?
Dear How to Do It,
I (28, she/her) have been with my spouse (27, they/them) for five years, married for two. We’ve had a loving, if relatively vanilla, sex life the entire time. Sex isn’t the most important part of our relationship, but we both agree we like to have sex about once every other week and it is important for our emotional intimacy. For some context: My partner has a penis and there is risk of pregnancy when we have sex. I’ve been on a very reliable form of birth control for 14 years, and we use condoms.
Here’s the thing: With the recent news about the likelihood of Roe v. Wade being overturned, I’ve become paralyzingly afraid of getting pregnant. I absolutely do not want children, ever, and I’ve known that since I was in middle school. The older I get, the surer I become that I want to remain childfree. My spouse agrees, and we discussed this very seriously before we got married. We are both careful, but have agreed should an unplanned pregnancy ever happen, I would just have an abortion. Now I’m completely panicking, and I don’t know if it’s rational. We use two forms of birth control, and I’m actively trying to find a doctor who will do a tubal ligation on a childfree woman in her 20s (no easy task). I also live in New England, so I know the risk of me not being able to access abortion services is low. But I still have 10-to-15 years of childbearing years left, and who knows what the legal landscape will look like. Since hearing this news, my sex drive is completely gone. The idea of having penetrative sex is making me physically ill with anxiety. How do I deal with this so I can return to the healthy sex life I’ve had for years with my spouse?
— No Kids, No Way
Dear No Kids, No Way,
It sucks that you’re going through this; it sucks that anyone who might need/want an abortion in the U.S. at some unspecified point in the future is going through this. I wish I could give you another perspective that would help show you that, actually, things aren’t so bad, but unfortunately, your anxiety is warranted. That it’s creeping into your enjoyment of sex, though, is worth seeking help for. No matter how natural the anxiety is, no matter how much objective sense it seems to make, it’s still fear of an as-yet-realized event, and it is manageable. Therapy might be useful; so might exercise—in Move The Body, Heal The Mind, Jennifer Heisz makes a persuasive argument regarding exercise’s ability to alleviate anxiety, and the science behind it. It’s also a solid how-to for getting into exercise for people who don’t currently have an exercise regimen. If that sounds appealing, check it out—it’s an easy read.
Regarding practical steps for reproductive health should Roe v. Wade be overturned, I reached out to Planned Parenthood, and Dr. Meera Shah, chief medical officer of Planned Parenthood Hudson Peconic, sent me a rather detailed and comprehensive answer which I’m printing below in full for not just your sake, but anyone else grappling with this news and what it means for their body:
Right now, people are concerned about their sexual and reproductive health and their agency over their own bodies—and rightfully so.
Being denied an abortion can cause physical harm. And we also know that being forced to continue an unintended pregnancy can cause financial, mental, and emotional harm. Even the threat of losing the ability to make your own health care and life decisions can put a strain on mental health and intimacy with a partner or partners.
The reality is that everyone deserves a sex life that is safe, healthy, pleasurable, and free from stress and anxiety. Here are a few things you can do to navigate sex and intimacy during these uncertain times:
Know your abortion care options. To be clear, as of right now, abortion is still legal. However, in the future, there will be significant hurdles to accessing abortion care for millions of people. These barriers will vary from one state to the next. You can always go to abortionfinder.org to locate your nearest abortion provider, or call your local Planned Parenthood health center to speak to staff who can direct you to care.
Make sure your birth control method is right for you. It’s true: birth control is no replacement for abortion. While abortion ends a pregnancy, birth control helps prevent pregnancy altogether. And regardless of how many birth control options there are, all people should also be able to freely access abortion care.
Still, right now may be a good time to evaluate the birth control you’re using, or would like to use, to make sure it fits your lifestyle, needs, and preferences.
Since you’re using two methods of birth control, you may have already figured out which options work best for you. But for the benefit of all readers, everyone should know that there are a range of birth control methods available, many of which are highly effective at preventing pregnancy. Some of the most effective birth control options include intrauterine devices (IUDs), the birth control implant, and the birth control pill.
Also, if it helps you feel more secure, barrier birth control methods—like internal or external condoms—can offer an extra layer of pregnancy prevention.
Lean into your support systems. During stressful times, it is important to lean into relationships with trusted friends, partners, and family members for support. You and your partner may find comfort in discussing any concerns you have around penetrative sex and lowering the risk of pregnancy.
You may also find it helpful to chat with a mental health professional to help you work through your feelings, fears, and emotions. Your mental health is important and there are professionals who can help. Individuals and couples who are experiencing anxiety due to sex—whatever the reason—may benefit from speaking with a mental health professional. This could be a reassuring activity—and even a bonding experience—for you and your partner.
Explore other forms of intimacy with your partner. On the heels of this upsetting news, many people may feel confused and anxious about their sex lives. Be patient with yourself, and keep in mind that even if you’re not comfortable with penis-in-vagina sex, there are other ways to sustain healthy sex and intimacy with your partner.
In the meantime, you and your partner may enjoy connecting through kissing, using sex toys, holding hands, mutual masturbation, or simply being close to each other. As an added bonus, these activities may also help lower your stress levels and help you relax.
Dear How to Do It,
I’m searching for resources, and completely coming up blank. My aunt is widowed and suffering from a type of dementia. She has been in an assisted living facility for about two years. Dementia has loosened her typically very buttoned-up demeanor, and she talks nearly every day about wanting “a man to snuggle in bed with” and about how much she misses touch. On a few embarrassing occasions, she has propositioned married men in the facility (and been turned down). She’s clearly sick in a way that impairs social skills, judgement, and her ability to consent, but at the same time, she talks about this a lot.
Are there resources about this? I looked for resources about mental impairments and sex education and found almost nothing. I looked for material on sex and the elderly and only found ghastly STI statistics. Her immediate family is buttoned up to the point of repression, so everyone is just pretending it isn’t happening.
— It’s Happening!
Dear It’s Happening,
Yes, there are resources—Dr. Stacy Tessler Lindau, professor of obstetrics and gynecology at University of Chicago Medicine, and her team at WomanLab put together this blog post that collects a lot of the available information (and some of the public discourse) on sex and dementia. You’ll see toward the bottom of the page even more resources, including some additional reading for caregivers as well as some videos. Lindau told me they put this post together specifically because of the lack of accessible information out there, so do take advantage.
I spoke briefly with Lindau about your question—she was about to board an international flight (was literally in the airport), but nonetheless graciously shared her time with me. This is an issue that she has studied (though specifically in home-dwelling adults) but that she says is nonetheless not discussed enough. Sexual activity in home-dwelling people with dementia is quite common—about half of men in that group and 18 percent of women are sexually active (the numbers are higher for partnered home-dwelling people with dementia).
Also common, according to Lindau, is the non-response of your relatives to your aunt’s display of sexuality. “I understand that, and it’s not an uncommon reaction, but in no sense is ignoring, denying, or repressing a person’s basic human needs considered to be a humane or kind way to treat somebody,” said Lindau. “It can be an uncomfortable or uncertain problem to navigate, but people with dementia deserve, I think and based on the based available evidence, an approach that recognizes them as whole people.”
Lindau emphasized how important she feels it is that your aunt’s humanity be honored. “It is totally normal for people with all kinds of health conditions to want to be loved and be touched and be snuggled, including people with cognitive impairment and dementia,” the doctor said. “Those are just basic human feelings. It is very possible that this woman is expressing a normal human desire. When people have dementia, it can be hard to express oneself in a socially appropriate way. I think the most humane approaches are ones that allow people dignity and understanding and compassion and recognize the desire to be loved and snuggled and touched is normal, but also works to protect people from embarrassing themselves or certainly from causing harm to others.”
In terms of what that actually looks like, well, it can’t quite be painted with a broad brush because everyone has different needs. “When people are living in an assisted-living setting or a nursing home, ideally—and COVID has made this difficult—they have longitudinal relationships, not just with the staff but also with the other residents living there,” she explained. “We get to know people and their behaviors over time. Even though they may not have the regular words to say when they’re feeling happy or when they’re feeling distressed, we come to understand their language—similar to what we do with young children before they have all their words. We can tell through body language and behavior whether they’re likely feeling safe and happy versus distressed and scared. Learning the language of people with dementia is the key. It’s something we all have to do, increasingly so, as more and more people have this condition.” Good luck. It’s very compassionate of you to want more for your aunt than what she’s getting. Your intuition is spot on, and I hope it serves your loved one well.
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Dear How to Do It,
I have a sex problem that’s also a marriage problem, and I’m looking for advice on starting the conversation. I’m a married mom of one child, and for a variety of reasons, I don’t want a second. My husband agrees.
We live in a state with a trigger ban on abortion, and the recent court leak terrifies me, since I’ve had unreliable experiences with birth control in the past. I’ve always been in charge of birth control in our relationship (my husband doesn’t like condoms), but I’d like to talk to him about getting a vasectomy. The thing is, he’s always been avoidant of even basic medical appointments unless there’s a dire need. To me, this is a dire need. How do I start this conversation?
— Let’s Snip
Dear Let’s Snip,
It’s difficult to guide you precisely here without knowing your husband’s sensitivities, but I think it’s key to lead with love while underlining how important this topic is to you. That might mean starting with a term of endearment, a compliment, or a straight-up, “I love you,” before announcing that you have something serious you’d like to talk about. It could also be useful to set your stakes early—state wherever you are on the scale of, “This is not make-or-break,” to “This requires a solution for the future of our relationship.”
But again, you’re going to have to tailor the introduction to your husband. What I think is more important is the meat of the conversation, and this is something I would bring up: For as long as culture as we know it has existed, women have had to take care of their own bodies. They have done this despite considerable distraction, coercion, obstruction, and animosity from men, who by and large have power. Now, men in charge (and their attendant supporters) want to exert more control over women; it is time for the men who actually care about women’s bodily autonomy to step up and do whatever they can to compensate for eroding legal protections. It is extremely easy for men to ignore the life-altering realities of carrying an unwanted pregnancy to term—to not consider this at all because it doesn’t affect their immediate lives and bodies. A movie that is out now, Audrey Diwan’s Happening, is set in France in the ‘60s (a place and time when abortion was illegal), and depressingly, it couldn’t be more relevant. Its young pregnant protagonist summarizes her predicament with precision: “I’d like a child one day. But not instead of a life.” (Incidentally, it might be useful for him to see that movie to understand the enormous impact an unwanted pregnancy would have on your life.)
The recent Supreme Court leak is indeed terrifying—it means, in part, that men who aren’t necessarily inclined to do more will have to, if indeed they support women’s agency and right to decide what’s best for them and their bodies. Many women will no longer be able to shoulder the responsibility of reproductive planning. Whereas previously your husband could skate by on medical wariness and his ensuing inactivity, his avoidance is now detrimental. That’s what happens when the world changes. He must do more. As you said in your letter, there is a dire need here. Impress that on him. It’s time for men to step up. It’s only fair.
More How to Do It
Recently, I went on a few dates with a man who repeatedly said he finds me gorgeous and is very impressed with my career. I thought he was a great guy himself. I gave him head, and he said it was “maybe the best head of his life.” Dude never texts me after that night. I didn’t text him either because I had initiated our last date. I’m being sexually rejected all the time and I am a very, very attractive woman…