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 wife and I have raised two great kids and have been married for almost 18 years. She hasn’t initiated intimacy for a long time. Nine months ago I had performance issues in bed and we thought it was my testosterone. After testing, my results were normal. But I took some supplements anyway and had to stop because of extreme mood swings.

I realized the problem was really that she always waits for me to initiate intimacy. I even asked her to try something different by using a vibrator to get her in the mood. I just wanted to try something new with her. Her response was to plan a night around it, but she said she was tired at the time. I am terrified that she is no longer attracted to me. I did make it clear that I need her to initiate. I don’t expect anything nice for Christmas or birthdays, but for the last few years, I have spent money on nice, thoughtful gifts for her, but haven’t received anything thoughtful in return. She mentioned recently that she doesn’t know about us after the kids go to college. It was a half-joke/half-serious, but it hurt. I have done everything I can, including losing weight myself and looking the best I have in years. I keep trying to discount my feelings because I am not trying to make myself out to be a selfish, typical pig of a man. Work is hard for her, and her mom isn’t doing well. I am working to be patient and if it doesn’t get better we need to go to see a therapist together. I feel so lost, and my self-worth is becoming a struggle. What should I do?

—Afraid My Partner Doesn’t Find Me Attractive Anymore

Dear Afraid My Partner Doesn’t Find Me Attractive Anymore,

What is it about your wife initiating that is so important to you? Why do you think you “need” it? And how can you be so sure of that if it’s not what you’re getting? Right now, you have a mere hypothesis that you’re attached to. I understand a general desire for engagement and attention. Having no uncertainty that your partner wants sex just as much as (or more than) you do can be a turn-on, sure. I understand why her initiation could signal her enduring attraction. But don’t take its absence as a sure sign that she’s not attracted to you. Sometimes we find ourselves occupying specific roles in our relationship and these roles can be hard to shake. If you’ve been the initiator historically and it led to great sex, your wife may be confused as to why this has to change, in which case more explanation (yes, perhaps in therapy) may be needed. Her desire may not be spontaneous, meaning that it might not just happen on its own. She may be more on the responsive side, which is to say that she may require erotic stimuli in order to get going. Asking her to initiate, especially after nearly 18 years, could be a tough assignment. If you have come to the realization that your desire is also responsive, and it turns out that hers is as well, it could pose a challenge to getting things going. (For more info on spontaneous vs. responsive desire, check out Emily Nagoski’s Come As You Are, part of the How to Do It canon.) A sex coach or therapist could help there too.

You should definitely revisit the comment she made about not knowing about your shared future once your kids go to college. You can be vulnerable here. Tell her that it hurt your feelings and has added to your insecurity. You can tell her that you have been wondering if she’s still attracted to you. Do not phrase this as an accusation and leave plenty of room for the possibility that you are misreading her. If you open up, maybe she will as well. I wouldn’t mention gifts because the point of giving them is not to receive back. Generosity means giving to give. I understand why you mentioned them in your letter and I see your point about this adding to the bigger picture of your insecurity, but to communicate effectively, you will want to avoid coming off as self-entitled or whiny. This ultimately isn’t an issue of what you aren’t receiving; it’s about your functioning as a couple and how lopsided it’s come to feel on your end.

Regarding your self-worth, it’s also understandable that it’s taken a hit in light of all of this. In addition to working on things with your wife, you should pursue things that make you feel good that have nothing to do with her. Perhaps this comes in the form of acts of service, either for the people around you or by volunteering. You have intentionally lost weight, so maybe you should keep some focus on your body by exploring fitness (either more of what you’re doing or different kinds of workouts). Create something. Spend more time with your kids. You are more than just a husband, more than just a sex partner. Your worth would still exist even if you and your wife never had sex again—you just have to find it.

Dear How to Do it,

I am a 36-year-old gay man who has been living a lie my entire life. I have reached a point where I can no longer deny who I am. The trouble is that my wife has no idea. We have three kids under 8. They are the reason I have remained in the closet as I don’t want to turn their lives upside down by divorcing their mother. Should I simply start seeing other men and keep it from my wife to spare my family the pain of splitting up, or is it time to come clean?

—Torn

Dear Torn,

Firstly, realize that seeing other men and hiding it from your wife and family will not be an easy lifestyle. Unless you and your wife don’t ever talk or check up on each other, this will almost certainly involve lying, deception, strategizing, hiding, and generally orienting your communication toward dishonesty. There will be no “simply” about it.

As difficult as the process can be, coming out is generally a decision that improves people’s lives. It feels better to inhabit your full self without fear or obfuscation. The way that we love and lust is fundamental to our humanity, so keeping that aspect of our lives siloed away and expressed only occasionally creates stress. A 2013 study in the journal Psychosomatic Medicine found that LGB people who were out had fewer psychiatric symptoms (described as “self-rated anxiety, depression, and burnout”) and lower cortisol levels (which suggests lower stress) than those in the closet. However, this is contingent on a person’s environment. In an interview about the study, lead author Robert-Paul Juster, explained, “Coming out might only be beneficial for health when there are tolerant social policies that facilitate the disclosure process. Societal intolerance during the disclosure process impairs one’s self-acceptance that generates increased distress and contributes to mental and physical health problems.”

Coming out may not be easy. It may be excruciating for a time if your wife reacts negatively. Reconfiguring your life will be a big task. But I think the long-term benefits of coming out tend to outweigh the short term pain. Once you get your life sorted, you will likely be happier. You have reached a point where you can no longer deny who you are. The stress and pressure associated with your current situation will be alleviated upon coming out. You can be in your children’s life, certainly. There are some mixed-gender couples that remain together even after one (or both) comes out as gay. You may want to read about mixed-orientation marriages, though they can be tough to navigate/endure.

I don’t think that staying in the closet for the sake of your family is a very good strategy, anyway. If you aren’t taking care of yourself, it’s harder to take care of others. The stress of the closet may present in ways that impede your relationships with your family. It’s very rare to hear someone say, “I wish I never came out.” Your life changes for the better and even if it’s different than it was prior to coming out, you adjust. You’re reading the words of someone who is much happier out than I was in the closet. I’m one of millions. Follow our lead.

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Dear How to Do It,

My husband of two years is a lovely and affectionate person. He enjoys cuddling and kissing, which I sometimes enjoy, but less than him as physical touch is not my primary love language. Recently, however, I find myself avoiding kissing him due to his bad breath. He has excellent oral hygiene (no cavities, flosses, and uses mouth wash daily), so I suspect his bad breath might be due to his IBS, which, according to Google, can cause it. I’m looking for suggestions about how to approach this topic gently without hurting his feelings.

—Stinky Breath Stress

Dear Stinky Breath Stress,

There are people who value this kind of feedback from a partner, figuring that if they can’t detect something awry or offensive emanating from their essence, well, at least someone in their life can. You get to be an extra set of senses for your partner. If one can accept that such feedback is given for one’s benefit (and not to make them feel bad or tear them down), it goes down a lot easier.

I would lead with acknowledging your husband’s excellent oral hygiene. This way, you signal to him that his bad breath is not his fault. He’s a victim of circumstance. Concentrate on reporting over editorializing. “I know you really take care of your teeth, but I’ve been noticing a smell coming from your mouth lately,” could be a way to ease into this. You know his sensitivity levels. If you can’t come right out and tell him you’ve noticed the smell, you can couch this information by saying something seems to be wrong. He’ll ask what and then you can get into it—this way you’re moving at a pace that will allow him to absorb the information. You can cite the fact that bad breath can be a symptom of gastroenterological diseases. It could happen to anyone with such a condition and is a good thing for him to talk about with his doctor, who may recommend probiotics or another kind of treatment.

I think as long as you’re gentle and compassionate, this should be fine (unless your husband is so hyper-sensitive, he perceives any such feedback as insulting). It is way more humane to tell him than to let him walk around with a stank mouth.

—Rich