My Boyfriend Is a Thrill-Seeker. His Latest Sexual Request Would Put Us in Danger.

How to Do It is Slate’s sex advice column. Have a question? Send it to Jessica and Rich here. It’s anonymous!

Dear How to Do It, 

My boyfriend “Drew” is a thrill-seeker and is into extreme sports and skydiving. He has a customized sports car he loves to drive and recently made a request to me that I think is a really bad idea. He wants me to blow him while he zooms down the highway. I’ve told him this is not safe for other drivers or us, but Drew keeps bringing it up. What can I do to open his eyes to how dangerous this is?

—Hot Rod Hazard

Dear Hot Rod Hazard,

You don’t want to give your boyfriend oral sex while he zooms around in a sports car because it is dangerous—for you, which is a valid enough reason to decline, and for other drivers in a way that would make you complicit by virtue of participation in any ramifications for the other drivers, which is equally valid. Drew keeps bringing up this desire of his that you have already declined. That’s him ignoring your boundaries and putting pressure on you through repetition. Repeated asking in response to a “no” is a coercion tactic. Whether he is consciously attempting to wear you down or simply impulsively applying a strategy he has learned is often effective in life, that’s not OK.

Don’t bother with trying to convince a thrill-seeker that his current quest is significantly dangerous. He knows it’s dangerous, and that’s the main appeal. Demand that he look at his behavior toward you and make changes. If he attempts to counter this with some claim that you saying it isn’t safe wasn’t a clear enough boundary, leave, no matter what apologies or manipulations he utters as you are on your way out the door.

Dear How to Do It, 

I read your column a lot, and I find it very helpful. I am a bisexual woman (who has never actually been with another woman sexually, but was madly in love with another woman many years ago, so that’s how I know I’m bi). Anyways, I have a long and frustrating history with sex. I was coerced into sex by my high school boyfriend, and then coerced again by the resident assistant in my college dorm. Then I felt coerced into marriage as a teenager by my ex-husband’s family and church because we had sex; that marriage ended seven years later in a huge, toxic explosion of abuse, severe mental illness, etc.

I was then drawn to my friend, who was the first man who was nice to me. I got pregnant and had our beautiful daughter. Although I did NOT want to get married again, we felt like we had to because he lived in Canada and our daughter and I were in the U.S., and we had to deal with COVID-19 travel restrictions.

I am now six years into a marriage where I perform my “wifely duties” about once a week, but I honestly don’t enjoy it. I mostly just dissociate and hope he cums quickly because I have such a bad relationship with sex. I feel like the only good thing sex has ever brought me is our two beautiful children. I know that many men divorce or cheat on their wives if they don’t get sex regularly. I try to talk to my husband, but he loves sex so much that I just do it to make him happy and try to get it over with quickly. Am I doomed to a life of hating sex? I have such bad self-esteem issues that even if I divorced, I know that I would just end up being with the next guy who is nice to me. And yes, I’ve been to about seven therapists over the last 15 years, and it has been helpful; I just haven’t found one I connect with lately. How can I make this better?

—Miserable in Sex

Dear Miserable in Sex,

I’m happy that you read the column frequently and find it helpful. I hope that all of that exposure has prepared you for the bluntness I am about to wield. Everything in your letter paints a picture of a life that has simply happened to you, and when you ask whether you are doomed to a life of hating sex, it suggests that this approach may very well continue. Regardless of what your childhood may have been like, and no matter what amount of awful sexual encounters and relationships you’ve had through your teenage years and into adulthood, you have the choice to start clawing your way toward a capacity to take control of your life.

I’m not suggesting that you should be able to wake up tomorrow and exercise every iota of autonomy that is potentially available to you consistently, but you can get to a place where you are not afraid to make your voice heard with your husband, nor certain that you would find the same pattern all over again if you left the marriage.

Take a hard look at what was helpful about your time with each of those seven therapists over the past 15 years. Something crucial was clearly misfiring for you to still speak about yourself and your life in the ways that you do. Was each tactic actually helpful, or did some mostly make you feel a bit better for a few days in a way that helped you ignore the actual problems? Of the specifics in your sessions that had long-term effects, are they still what would help you right now? What are you looking for when you’re evaluating connection—is it feeling cozy or feeling like there’s mutual comprehension and a capacity for them to support you in making the changes that can make your life and relationship to, well, relationships, better than it has been?

If you want to shift the conditions of your life and the ways you live it, and you’re willing to challenge yourself, I think you can get there. And, in the somewhat common event that you can’t quite do it for your own sake right now, remind yourself of the impact the example you set is having on your children. If being reminded to put your own mask on first helps get you over the first hurdle, use that.

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Dear How to Do It, 

I’m on the minimum effective dose of Ozempic. From a medical perspective, everything is great: I lost weight, I’m no longer prediabetic, my polyendocrine metabolic ovarian syndrome (PMOS) has reduced severity, and I’m even just barely in the healthy BMI category for the first time. I’m also miserable.

I don’t find pleasure or interest in food; I no longer tolerate alcohol. I used to be an avid swimmer, and I still go daily, but now exercise is mechanical, like everything else. Hobbies I used to enjoy are not worth the effort. But mostly, as a former enthusiastic slut, I have no drive for sex. I’m conventionally attractive for the first time in my life, and more people hit on me now than when I was fat, horny, and joyful. And I feel nothing.

My doctor suggested depression and referred me out. I tried several antidepressants, including Wellbutrin. Nothing happened. I tried masturbation. I tried sex with a trusted hookup. I tried sexting on the apps. None of it got me anywhere. My doctor and I both think it’s the Ozempic. My physical health and dodging my genetic risk for diabetes matter, and PMOS makes unmedicated weight control famously difficult. But what’s the point of a “healthy” body if I can’t use it for any pleasure? I can’t figure out what to do if I have to choose.

—Healthy and Feeling Nothing

Dear Healthy and Feeling Nothing,

If the only negative feeling you’re having about the changes in your appearance is frustration that you no longer have interest in the sexual interactions you’re receiving more frequent overtures toward, then, in the context of the lengthy list of other activities you no longer enjoy, I’m inclined to agree with you and your doctor that Ozempic is the main factor, and an evaluation for depression makes sense. I do have some questions, though.

Were you referred to a psychiatrist, and did that psychiatrist do a full evaluation before prescribing medications? When you were trying these several antidepressants, did you try each one for the duration of time that they usually take to show significant effect (which can be up to a couple of months)? Did the prescribing doctor give you any guidance around how long to wait between stopping one and starting another? And was there any exploration of whether coinciding life events or the changes in your physical form themselves might be some aspect of what you’re experiencing? If the answers to all of these questions are “yes,” ask about non-medication options.

Given that GLP-1 drugs are still extremely new, and some studies are suggesting that they alleviate mental health symptoms while other studies suggest increased risk of depression and anxiety, my only surprise at this BBC article about how GLP-1s affect the brain is that the headline quotes one scientist as bluntly stating, “We have no freaking clue.” Usually academics leave that kind of tone and candidness to the likes of columnists. Therefore, I think you might want to seek out a psychiatrist who is interested enough in GLP-1s to be following the research as it develops, and therefore be better positioned to make highly educated speculations about what could work for you. If you can find one who has a longstanding specialty in people who have hormone disorders (or even, specifically, PMOS), even better, as this might be a relevant part of your personal picture (and strikes me as increasing the likelihood that they’d be motivated to do continuing education around the GLP-1s). You also might look for specialists who are working on things from the GLP-1 side but are interested in the mental health effects.

It’s also worth accepting that the things that used to bring you pleasure aren’t doing so right now, and looking at things you haven’t tried, or tried and were unmoved by a long time ago. This is absolutely a long shot, but your health is important. There is a strong argument to be made that the point of a healthy body, even without pleasure, is living. There’s the possibility that without this treatment, PMOS or diabetes might bring you to a similar state of wondering what the point is, over a longer period of time but without the option to stop taking the medication. I’d pursue options for balancing out the anhedonia you’re describing for as long as possible before moving to weighing whether to stick with it or stop the Ozempic. Partially because if there’s little understanding of what these medications are doing to brains and mental states, there’s even less knowledge about what stopping and restarting could mean. And if it does get to that point, do your best to understand the probabilities for coming off the medication and how PMOS and prediabetes may play out from that point so you’re making your decision in the context of what information is available to you at that time. The more solid and methodical our decision-making processes are, the more we tend to be able to accept the outcomes of the choices we make.

—Jessica

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