But the ER doctor wasn’t insane - they
also were seeing car accidents, and noticing that these were fewer and less severe than the motorcycle ones. Stats back them up - a quick google tells me motorcycles have 6-24x the fatality of car accidents, depending on what you’re measuring.
I sort of feel like the ER doctor of relationships - when I worked as an escort, I got to see lots of people who were using me as a solution to a failing marriage. I laid with them and played a therapist-esque role, asking them about their lives, their feelings, their wives.
There was one married man who said he’d never cheated before. “Twenty-six years, I was faithful”, he said. He was a large, balding fancy-lawyer who told me sternly to stop using a certain makeup product, he’d just finished a class-action lawsuit against them. It was a five star hotel, a six-hour appointment, he was no-nonsense and a bit gruff.
"Twenty-six years,” he said. “I love her, but she just lost interest in sex. After kids, and she gained weight and felt bad about herself, and I don’t know. I tried lots of stuff, we did some therapy, but nothing seems to make her want sex. And I just put up with that, I didn’t have sex for seven years.”
This was after he and I had sex; I was laying with him naked on the giant king bed in the penthouse suite he’d rented and probably wasn’t going to spend the night in. I stroked his arm, dusted with grey hair.
“That sounds really hard”, I said. “What made you decide to start seeing escorts?”
“I found out I had cancer and was gonna die,” he said. “It really put everything into perspective. I suddenly realized I didn’t want to leave this world without ever having sex again. And I couldn’t bring up the idea of seeing other women to her -” he winced, imagining. “She would not like that, I think if I even mentioned it to her everything would fall apart. It’s just not the sort of thing we can talk about, yknow? Anyway, so I started seeing escorts. I’m not really proud of it, but it’s you know - safe, you’re not going to try to ruin my life or anything, it’s separate.”
After a moment of empathetic silence I asked, “So… how’s the cancer?”
“Gone”, he laughed. “Or, in remission, at least. It looks like I’m gonna live. But I decided I wasn’t gonna stop seeing escorts.” He winked and squeezed my boob.
I can’t tell you the amount of times I saw men enter my clinic with severe motorgamy injuries. I heard the same story over and over, with small variations on the amount of years and the guilt they brought with it. They professed their love for their wives - she’s sweet, diligent, hardworking, hilarious, the most important person in their lives. They talked sadly about her loss of interest in sex - hormonal, medical issues, too busy, she doesn’t like how she looks, or no cause they could figure out at all. They told me
what they’d done to try to fix it - therapy, long discussions, proposing novel sexy stuff to spice up their life, watching porn together. They told me how nothing seemed to work. Oh, something would change, briefly, like a spark of hope now and then, but it would sink back to the same old. “I haven’t had sex in a year”, they’d say. “Two years”. “Ten years”. They would look away sheepishly, full of guilt. “She doesn’t know I’m doing this”. I’d ask if they tried talking to her about it? Brought up getting sexual needs met elsewhere? And their body would cringe: from a “I tried that and it didn’t go well” to the occasional “No, no I can’t do that. I think she’d divorce me if I asked.”
Of course, not all men were driving carefully. Some readily admitted they hadn’t done much to try to fix the problem; others said
they weren’t attracted in their wives, even though their wives were down to have sex. Others told their story in a way that made me suspicious; their role was too innocent, hers too unreasonable, and I figured if I talked to their wife I’d get an
entirely different story.
But these were the minority; there was a clear core,
one of men in long-term marriages unhappy and struggling with their unmet need for sex.
(Women can also be unhappy! The issue goes both ways, for many reasons. As an escort though, I dealt with the male side, and males in general tend to more frequently be the ones with an unmet need for sex. In this article I’m talking about men, but I want to clarify that women’s side is equally as important and much of this can apply to them too)
With a lot of help from
David Ernst, I made
rankthings.io, a site where you can rank things you value. On average, men rated “a fulfilling, active sex life” as #6 - more important than not getting their thumbs cut off, having 5 million dollars, extending their life 100 years, having perfect mental health, the ability to wear shoes, and the ability to listen to music.
(By contrast, women rated it as #13 - less important than their thumbs and perfect mental health, a good relationship with their parents, feeling well rested after 5 hours of sleep, and a job they like that pays 3x the usual salary”)
Dead Bedrooms is a subreddit for people with partners who’ve lost interest in sex, and has over 400,000 members.
See this post, of a post that almost sounds verbatim like it could have been from one my clients.
Or this one, of a man whose wife initially deceived him about her sex drive,
or this one, or
this, or
this.
In my data, men in long-term relationships, on average, were more dissatisfied than satisfied with their sex life.
In my data, men in long-term relationships, on average, were more dissatisfied than satisfied with their sex life.
Whether it’s
good that they decided to solve this issue via escort is a bit debatable - they
did promise exclusivity, after all, and lying to their wives is very clearly
bad. But the exclusivity choice was made by their past self, decades ago- a different person, to a different woman, and I can’t help but wonder if they would make that same choice if they knew what they were getting into. If the man I was laying in bed with could go back in time to warn the young man at the altar - would he have gone through with it? I don’t know.
We feel uncomfortable with young people going into massive debt to colleges in exchange for an education - did they
really know what they were getting into? Did they have the capacity to understand the burden they were placing on their future self? And maybe you might argue sure - they made a pledge, they’re obliged to stick to it - but even if we say the right thing to do is to suck it up, you’ve still got to at least feel
some sympathy. They were promised that by going to college, they’d be guaranteed some sort of life stability, a path, a good job, but instead found themselves crushed decades later under a life that had turned more into tragedy than the dream.
Of course, for many, it works well! Most people who drive motorcycles don’t crash, after all. But I’m not sure, knowing what I know now, that I would recommend my child drive a monogcycle. The difference here is that the ER of relationships is invisible - played out in front of escorts in hotels, in the privacy of client-therapist relationships, in affairs with coworkers. We’re incentivized to hide it - if word ever gets out that you’re in the ER, your life might very well explode in your face.
According to my data, over 40% of men in relationships over 22 years reported cheating. Maybe this is selection bias, but
probably not significantly.
(To summarize: my data shows slightly higher rates of cheating than other, properly randomized studies when binning by age, but there’s a good chance this is mostly due to a combination of me surveying less religious and more unmarried people)
In my data, 36% of monogamous men in relationships 22+ years reported having sex once a month or less. 16% said they either never had sex, or had sex very rarely (less often than a few times a year).

Did you know 14% of all traffic fatalities are from motorcycles?
When I talk about the downsides of monogamy, I mostly have in mind the long line of sexually unhappy older men after decades worth of relationships, but most of the people who disagree with me are young. They’ve been in relationships for six months, five years, an occasional eight years, and assure me that the need for sex is overblown. It can’t be
that bad, not really, they value other things, they’re committed. But I do wonder how many of these underconcerned people I’m talking to will one day end up as one of that 36% who have sex once a month or less, or the 40% who report cheating, or the
25% of clients in bed with me, telling me sadly how much they love their wife, they just wish things were different.

Who will they be 20 years from now? Will they make the same argument then?
Of course, other accidents still happen. People still die in normal car accidents too, but polyamory accidents are
way more visible; crashes are blamed
on the polyamory over anything else. If jealousy causes your throuple to go down in flames, the monogamous people stand by going “man, poly looks like a nightmare.” But nobody looks at marriages exploding in divorce when the wife catches her husband cheating and sighs over coffee going “That’s what happens when you try monogamy.” The failures of monogamy are invisible, integrated, the blame redirected to the
selfish, horny men who can’t control themselves. Their inability to make monogamy work is
their failure. By contrast, when people fail to make polyamory work, we’re quick to blame the polyamory itself.
(To be fair, this is kind
of true? In my survey of 23,000 people online, people who marked themselves as partially polyamorous, rated their relationships meaningfully worse than monogamous ones. Fully polyamorous people, though, rated their relationships better than fully monogamous ones, reporting an average relationship length of only 2 months shorter on average.)
Realistically, these 20-40% of supposedly successfully monogamous men in long-term relationships aren’t really behaving monogamously at all! They’re engaging in an unethical version of polyamory, and, while not great, in many cases this is still
saving their relationship. Often they’re otherwise happy with their marriage, but the need for sex is too great - and so it builds up and offgasses safely into the escort realm, thus preserving the rest of their relationship from exploding.
Our concept of the long-term, stable monogamous marriage is partially an illusion. If you think poly explodes and monogamy doesn’t, you’re falling for that illusion.

source
You might argue we live in a society full of selfish degenerates who don’t care about their marriages - but if 40% of people are crashing at your intersection, maybe you should stop blaming the drivers and instead take a closer look at the intersection design?
As a teenager, I lived in a strict Christian world where masturbation was a sin, and thus a violation against God. It was
bad for me, it would
corrupt my soul, it was rebellion, it was betrayal of my values. And yet, despite wholly believing this, I still masturbated, and then felt like a terrible person. I just couldn’t help myself; my biological need was far too powerful.
In hindsight, do I view myself as a bad person, deliberately engaging in actions I genuinely believed were harmful? Shouldn’t that be the definition of a bad person? No! Instead the whole culture seems tragic - it demanded more of me than I was capable of giving, and shamed me for my inadequacy. The hoop was impossible from the get-go, I was destined for failure, and I suffered greatly as a result.
And to be clear: there’s also lots of happy, sustainable monogamous marriages! The dream is
not impossible - the dice rolls favorably for some, many long road trips are taken fatality-free. This post is
not about those people. If you want to aim for monogamy, and you have reason to believe you’re not at risk for accidents down the road, then
do it!
But the issue is that for some people, monogamy as we know it stops working, and there’s no cultural recourse, no mechanism to fix this. We are
far too rigid as a culture about the sexual needs of older men, we blame them for failing when it’s the system that demands too much.
I’m not saying everyone should throw themselves into orgytastic polycules - it’s
not right for most people, and that’s fine. I’m not saying the right choice is for these men to just go off dating other people, or juggling multiple relationships, or joining a swinger’s club. I
am that expecting people to live happy lives when they have a strong need that we
forbid them from meeting is stupid and cruel, and the first step is at least to be able to have an open discussion around it without resorting to blaming them as failures. I’m saying that we
already see underground non-monogamous behaviors emerging to try to both get sexual needs met and maintain committed relationships, and that figuring out new cultural norms to work
with this, not
against it, is the compassionate thing to do.