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I just want to say that I feel horrible for this guy. It sounds like he's been depriving himself for the sake of his wife for nearly half of his life. And, further, I'd argue that his wife is being emotionally manipulative in threatening divorce for any infidelity. Here's a man who's put his needs secondary for the better part of two decades and she's willing to let that go over a little sex? Sex that would probably make her husband more patient with her? It also seems rather short sighted and masochistic on her end. After all what chance does she think she has of finding someone to love her, marry her and stick around for 18 years while she never has sex with him? This seems like a recipe for an eventual divorce - a divorce neither party wants - over a little bit of sex. What a shame.
Also, I so want to offer this poor man a pity fuck. I can be discreet (the offer on this post notwithstanding).
Depending on the answers, I'd suggest he see a lawyer about filing for divorce himself, not in anger, but in sadness, and move on unless she's willing to reach some accommodation. If she's still not, then it's definitely time to go.
So he needs to remind her of how patient and understanding he has been for EIGHTEEN YEARS. He should tell her he loves her but that he just can't live this way forever. She needs an ultimatum. She must either find a way to stomach having sex with her husband (And if she really cares about him, she will WANT to want him, which should make the process easier to swallow) OR she must allow him to find satisfaction elsewhere. If she can't do this for him, she doesn't deserve to keep him.
True love is selfless. It's not always effortless, but you should always have the desire to make your partner happy. Otherwise, it's not an equal relationship. To me, THAT'S a deal-breaker.
He already isn't in a monogamous marriage if he never has sex with her.
I would say her fears are real and should be addressed, but not at the expense of his real needs.
I would suggest reading up on open marriages. Find a book he likes that has the right tone for him. After an introductory discussion with the wife have her read the book. This could give her a way to asses and process her feelings about the possibility of open up the marriage.
One option is to very carefully and very occasionally cheat, preferably with professionals, since they're likely to be more skilled at the secrecy game. I think it's an inferior option, because it's a clear betrayal of her trust,
The better option, ethically at least, is to sit down with her and explain the true nature of the situation. She will cry but in this particular case you need to push through. She needs to understand that the status quo will not work. Tell her you love her, and tell her that for years you've honored your monogamous relationship and gone without something very important to you, but that it's slowly driving you crazy. Tell her you don't know when you'll be pushed beyond the breaking point but that it happening is a matter of when, not if. You'd rather be sexual with her, but you could accept some degree of liberty as a secondary, inferior option. However she must leave the conversation understanding that this will eventually break your marriage, that you can't live the rest of your life without sex. You'd rather be sexual with her than others, and you'd rather be sexual with others than divorce, but one of those three things will have to happen, and she needs to decide which she sees as most possible and tolerable.
It seems like the difference between consensual and nonconsensual monogamists is the faith (yes, I said "faith") that their partner can have a rational, reality-based discussion about the subject without turning it into a constant fight or source of fear, guilt, and paranoia.
Because that's really what it comes down to, right? You either take the risk up front and potentially get the greater pleasure returns later, or take the pleasure now and make the high risk payments for the rest of your married life.
It could well be worth it, though. He's only 40. There's still time for happiness.
anxiety if she is not willing or able. Of course it may not help, but not talking about it doesn't help either. I really feel for them, life often takes us places we don't want to go. It is sad that she is so ill, I know I live my life with a chronically ill person who is in pain and it is so easy to allow the illness to run the show. It's easy to grant the ill person extra grace, and they need it, but the illness needn't have so many victims and steps should be taken to lessen its ability to victimize others. That is my $0.02, but I would throw monogamy out the window if it meant that my life partner would have to suffer less. I couldn't ask him to be sexless or use the
gift of masturbation as his only sexual release.
That's what gets me about these letters about one spouse being sexual pre-marriage, then after the marriage shutting off sexually. Is this not deceit, fraud, not following the rules? Is that not the definition of cheating? That's where I think Dan's advice in general at least gives some situational equity to the concept of "cheating".
–verb (used without object)
4. to practice fraud or deceit: She cheats without regrets.
5. to violate rules or regulations: He cheats at cards.
6. to take an examination or test in a dishonest way, as by improper access to answers.
7. Informal . to be sexually unfaithful (often followed by on ): Her husband knew she had been cheating all along. He cheated on his wife.
I guess it fails in the common usage of #7. Can we change that please?
7. Informal . to be sexually unfaithful (often followed by on ). Her husband stopped going down on her after the marriage. He cheated on his wife.
Actually that is confusing. Thoughts?
7. Informal . to be sexually unfaithful (often followed by on ). Her husband stopped going down on her after the marriage. He cheated his wife (out of orgasms).
Sorry, clearly not a monogamust answer but I couldn't resist.
been a part of this relationship for most of that time" though he entered the marriage thinking sex was on the table. And since the only reasons he gives for his wife refusing are illness related I'm inclined to think that the illness began nearly 18 years ago.
been a part of this relationship for most of that time. I am very sexual and have always been so." -- This caught my attention. Why has he waited so long if the sex has been non-existent for over a decade?
Yes, it is important to fix a broken situation, but letting it linger for a long time gives an implicit "thumbs-up" to the other person, leading to a lot of pain should he leave now. What was he thinking when he entered into this marriage? Is there a cause of her pain, and is there a treatment?
For someone so stuck on some parts of monogamous marriage - "made a deal to stay" - he didn't seem to think the other parts through - marriage usually involves having sex and agreeing on frequency. He should divorce, cough up whatever financial support she's entitled to, and move on. They're stuck in an 18-year rut that hasn't gotten better; I doubt that counseling or an affair is going to improve things. Better to let her go quickly so she can find someone who is satisfied with her and he can find someone who satisfies him.
I want to be the Devil's Advocate, and say that you really can live without sex. Perhaps a good many people think they cannot, but what they mean is that they want it so much that will have no control over their actions. Well, either you don't, in which case you should be pitied, or more if what you can't control damages others or you do, in which case you can do your own cost-benefit analysis and act accordingly.
I don't know if this person needs "sex"; I think it very possible that he more needs "sex with wife", which has a tonne of associated meanings...I think if he turned elsewhere, he would have to imbue the new partner with a level of significance that would ruin his already-shaky marriage.
For me, I think I would stay, and remember that it is better to masturbate than to burn (metaphorically, not in literally in Paul's mythical horroshow).
(The longest 'dry' period in my life? Seventeen years, for twelve of which I was conscious. I lived.)
Yes, her friends and relatives will hate him. Oh well. Maybe it's a good time to move to another city anyway.
Suck it up. For better *or worse*, in *sickness* and health, you promised to be monogamous and forsake all others. A marriage is bigger than the 2 people in it, it's a commitment and a promise and it means more than fleeting pleasures or jerking off into a person instead of a tissue. You made a promise, without being able to see the future, to not have sex with anyone besides your wife. Unless you wrote it into your vows, the "unless you turn me down because then all bets are off" loophole wasn't there for her to agree to or object to. If you'd gone into this as an open marriage, that would be one thing. But you sold her on the idea of a lifemate who would be faithful to her and support her until she died. It's a bait and switch to give her an ultimatum now. Is it fair that she's sick and in pain and doesn't want sex anymore? No. Did anyone ever say life would be fair? Not to me, they didn't. She has, through an illness, made your marriage less than ideal. You're asking for permission to, through a refusal to see sex as a want rather than a need, make her marriage miserable and devastating.
Jerk off. A LOT. Have all the orgasm you want with all the famous hot willing flexible women you want, but do it without anyone else in the room. Buy lots of porn, or learn to photoshop it yourself, and have at it. But before you decide to hurt your wife, just do the decent thing and divorce her. She deserves someone who finishes what he starts before starting something new.
Find a sex-positive therapist who isn't averse to divorce being a solution. The husband should go in alone, first, and explain to the therapist what and why he feels how he does. Then bring the wife in, and have the therapist help explain the problem, figure out where she's at, and DON'T STOP therapy until a solution has been found that both parties can live with. If the solution stops working, GO BACK to therapy. If a solution cannot be found and the therapist agrees divorce would be better for both parties, then get as friendly a divorce as possible. And start dating other people.
Particularly if there are kids involved, a husband shouldn't risk looking the The Bad Guy by cheating. Do it honestly -- there may still be hurt feelings and resentment but it won't fester and ooze the way found out secrets do.
You need to choose whether sex or your wife is more important to you at this point. If she'd rather that you end your relationship with her than go behind her back, you need to honor her wishes and either get a divorce or stay celibate.
Never mind the notion that people should be allowed to revisit their former commitments when they become unsustainable. You allow for him to divorce his wife, which sure as fuck is an explicit violation of "till death do us part", so how then do you justify him trying to stay sane in some way (hopefully with permission) after she has unilaterally violated the implicit assumption of a marriage with sex?
Listen. This wasn't what he signed on for. He signed on for a partnership. She has a duty to make an effort, to meet him halfway. She isn't. Sure, she probably feels horrible about it, sure it makes her cry to think about it, sure she feels guilty for emotionally manipulating him whenever the subject comes up. Tough break. She needs to make an effort, provide an accommodation, or let him go.
Ulyimatums should be rare in marriage. So rare, in fact, that more than one per spouse is almost always uncalled for. But now is his time to make one. It should be:
I love you, but I cannot live like this anymore, so you have three choices:
1. Put some effort into the long-neglected sexual aspect of the relaitonship; or
2. Let me discreetly and safely seek sex elsewhere; or
3. Let's get divorced.
Pick a choice. If you need a couple of weeks or some counseling to help you figure out what to do, let me know.
Good luck, LW. I recommend divorce, myself. But you owe it to yourself and her to give her the options.
I disagree (and I think that a lot of other people will too) but it's a fair commentary, and not dickish and blunt without being finger-wagging. Thanks.
I know if I was married to this woman and she was jelous of me leaving her for others I would feel like I actually need to seek more than just sex outside of the relationship. It sounds like she might be clinging onto what he provides without being willing to provide anything, even flexibility, in return.
It is too soon to tell but he might need to DTMFA.
Because this situation is long term, it is an extreme example that illustrates what constitutes a need and who is responsible for satisfying that need. I'm sympathetic to the wife not wanting her husband to have lovers, but it is unacceptable to demand fidelity from someone without doing your best to fulfill their real needs.
My advice is, "Leave your wife, tomorrow. Denying you sex with her AND with everyone else is unfair. And next time, before you decide to get married in a fashion where you're making promises that extend the rest of your life, consider how absurd that is, given that change is a universal constant and that a majority of marriages end in divorce (as opposed to death)."
Then she's a fucking idiot for this bit: "I know she would divorce me if I cheated. There’s no doubt. I feel pretty confident that having open marriage would be off the table—she is very jealous. She takes fidelity very seriously."
If you're thoroughly dependent on a marriage for survival, making unreasonable/unrealistic demands (I don't consider e.g. "Don't beat me" to be unreasonable; I do consider "Never have partnered sex again as long as both of us are still alive" to be thoroughly unreasonable) in the context of that marriage is suicidal.
This is part of the for better, for worse that he signed on for. It's lousy, but as Dan can attest to, it is not rare.
That said, I'm not convinced--with how little is here--that he cannot reach a happier outcome with his wife. It sounds as though he is deeply concerned about her and her illness, but I wonder how he talks to her. I often have been surprised how inarticulate and/or hesitant some people can be, even about very important topics. Some cannot bear to hurt someone, cannot stand being "the bad guy." So they downplay how important something is to them or they get weirdly passive aggressive, etc. And they tend to routinize these types of conversations down to a not-very-useful script.
Clearly, if his wife has been sick for a long time, she didn't get the life she had hoped for, either. A frank conversation, perhaps with a mediator of some sort who won't impose his/her values on the outcome but will push for honesty and respect of one another's preferences, would probably be a good starting point.
I say get a divorce. Period. If this person forces her into sex, it'll be joyless, sad sex and then he'll be the bad guy for manipulating her into it and then not being satisfied with it. If he gets some on the side--he says she's jealous--there's no way to beat around that short of actually lying to her. I think divorce is the only option. This person might love his wife but she is physically capable or wiling to love him back. Cut the months of suffering through trying to compromise, cut your losses, and get out.
I on the other hand, have no advice but wanted to say that a sexless life is my worst nightmare. I love sex more than pretty much anything. It really freaks me out to realize there are tons of people who go thru this shit, lives of no sex. Not really a life is it?
It's the disadvantage compassionate, rational people always face in a dialogue with zealots: We have rules for what is reasonable, and for what is right. They have none.
He doesn't just want sex. He doesn't just want sex with his wife. He wants his wife to want to have sex with him.
And she doesn't. And she knows that's what he wants and she knows that she can't give him that...
This is rejection at a core level...and the only way to solve it is for somebody to be the bad guy and hurt someone they love more than they're currently hurting--to hurt someone so bad that they accept the inevitability of change.
And even with change, there's no guarantee of happiness...because I don't think anyone in this scenario will end up getting what they want (although one person is guaranteed to always not get what they don't want.)
I say the "counseling failed" thing is just silly. Keep looking for a therapist you can both engage with and have the courage to explain the whole situation, and the whole history. Those couples counselors have heard it all. Believe me, they have heard it all over and over and over. Persist, tell the therapist that you are shopping around and would like to meet to lay out your situation, and put energy into finding someone who can help. (Some of them won't even charge for that first meeting b/c they are checking you out as potential clients just like you are checking them out as potential helpers).
Unless you just want someone to give you permission to file for divorce or find an outside sexual partner. If so, you have my permission.
Key point: People are often afraid that their partner will leave them if they open up their marriage, but in fact: there is NO guarantee a partner won't leave someone in ANY relationship -- monogamous or not. If she cares at all about her partner, then they must work through these fears and not let them be a stopping block. She is denying him a fundamental, and fun, part of life. And while he said he's staying "no matter what", this is a pretty big what to have matter.
OTOH, is it possible that "this guy" (what? not acronym?) isn't standing up for himself. If she just cries and throws emotional tantrums whenever something uncomfortable comes up, then that becomes a dysfunctional relationship, because he stops bringing up things that are uncomfortable and changes his behaviour because he fears her reactions. Partners have to be able to work through uncomfortable and difficult conversations without emotionally manipulating the other one. If she can't do that, then she need professional help. And they need a counselor or professional mediator.
I don't want to suggest divorce (although I don't consider divorce a bad thing, sometimes relationships need to end, or just end naturally... that's pretty normal) ...in part because it is far, far too common for men to leave women if the women become sick or ill, whereas women tend to stay with men who become sick or ill. So, bravo for being a solid partner! But he has made some considerable -- and unplanned -- compromises for the relationship. Perhaps she needs to make some too.
The line in full usually goes, "Will you love him, comfort him, honor and keep him, in sickness and in health; and, forsaking all others, be faithful to him as long as you both shall live?" Why does everyone assume that these vows only mean that the well person has to love and comfort the sick person? Why is there not also an obligation from the same vow for the sick person to love and comfort the well person? It can, and I believe should, be read both ways.
The man is clearly distressed at being celibate for this long. If she will not comfort him, hasn't she then broken her vows first? She's clearly physically able to give him hand or blow jobs and have sex play even if penetration isn't possible. And despite being ill/depressed, she's probably still emotionally able to put on her game face and pretend to enjoy it.
Contract law says you only have to hold up your end of the deal if the other person is holding up theirs.
Sexual satisfaction with no change in emotional ties. their relationship will improve. the economy is strenghtened thru the exchange of services and money. Win-win-win
While all states now have "no fault" divorce, traditionally a divorcing spouse needed to show some ground for why the marriage should be terminated. The causes one could allege included cruelty, abandonment, and lengthy imprisonment. The monogamusts will be happy to know that adultery was also considered grounds for divorce. They may be less excited to learn that lack of sex was also grounds for divorce. And no, there were no exceptions for age or illness (unless the illness and consequent lack of sex was disclosed prior to the marriage).
In other words, the traditional viewpoint was that cheating on your spouse broke the marriage. But the traditional viewpoint was also that not fucking your spouse similarly broke the marriage. In other words, withholding sex was considered just as damaging to a marriage as cheating, even if the withholder did so through no fault of his/her own.
So lets stop pretending that people should be forced to endure sexless marriages. Even back when divorce was difficult, we recognized that people enter into marriage with the expectation of sex, and that lack of sex is a valid reason to end the marriage.
It seems to me that "staying sane" by discretely getting sex elsewhere is the best solution given that he loves her and wants to continue to care for her and live with her. Because--and I haven't seen the "Get more counseling people" acknowledge this--would you want the only sex you can expect for the rest of your days to be obligatory sex? I think that would be a worse sentence than forced celibacy.
But, again, sick or no, this woman is horribly selfish and cruel and manipulative.
I ended up talking to a coworker a few weeks ago about a Savage Letter of the Day and this coworker said definitively that once one person in a marriage says "Yeah, the sex part is overwith" the other spouse must either accept it or divorce. Period. No exceptions. She was so adamant that she was stunning in her selfishness and cruelty, but what amazed me is that the righteousness of her position ("adultery is always wrong") protected her from that insight into her own shortcomings. She was as convinced of her righteousness as I was disgusted by her selfishness.
This is a hard one, because I would not leave my partner of 20 years if he suddenly could no longer have sex, but I might have if this happened earlier in our relationship, or if it was something he refused to even discuss rationally. Just my 2 cents....good luck.
I think I am a monogamist because I cannot abide the thought of my man having sex with another woman. Not the actual intercourse, but all of the fun and intimacy leading up to the intercourse. That's the good stuff - that's our stuff - and the idea of him doing it with anyone but me is a huge betrayal.
With that definition in mind, I can understand why she has a strong negative reaction to an "open marriage." Frankly, I am embarrassed that I have a similar reaction. But where, as here, they don't have the good stuff - the fun and intimacy leading up to intercourse and orgasm - there seems to be less of a betrayal.
I can't imagine a sexless marriage. It sounds like a really lonely place. But if I wasn't having sex with my husband - if we weren't having all of the good stuff up to and including sex - then I also have a hard time imagining his extramarital liaisons as betrayals.
Anway... if you can work while in pain, you can do other things too. It's a matter of priority - you might have fewer spoons than everyone else, but you put them in the places that are most important to you.
Why isn't the wife prioritising sex? Either the husband hasn't made it clear how important it is to him, or we're back to different sex drives territory. I don't think the issue is about whether or not nonmonogamy is the answer to the husband's situation. It's about why they can't have a proper balanced negotiation. She has to stop blackmailing him, and he has to stop treating her with kid gloves - if one person is sick you have to work really hard to stop it turning the relationship into an unequal one.
That is indeed emotional blackmail. If there are no kids, leave. If there are kids, see sex workers. Your wife is not being fair to you. I'm so sorry.
Re: sex is a "want" not a "need" (several commenters)
Sex may not be not an individual "need" but it is most definitely a collective "need". The race "needs" people to have sex in order for the race to continue.
Because of this, people are wired for sex in such a way that the choice is not always left completely up to the individual, at least not to the conscious mind of the individual.
Subconscious/collective forces come into play in matters of sex. You can pretend that it is otherwise, but you do so at your own risk.
I should say ... *individuals* can pretend that it is otherwise, but they do so at their own risk.
That said, divorce her for god's sake. I don't know where all these people are getting the idea that monogamists always think people in sexless marriages should stick it out. I've already told my partner that if he stops putting out, I consider it grounds for divorce, and I mean it. Part of a relationship is sex, plain and simple. She needs to either give him permission, or he needs to divorce her and find someone more appreciative and caring about his needs. None of this running around behind her back shit. Not only is that a bit cowardly (he can't stand her tears), but she's bound to find out sooner or later, and when she does there will be hell to pay. He thinks the situation is bad now, wait till she finds out, has a meltdown and THEN they end up divorcing. This marriage doesn't seem like a very healthy thing for anyone involved. It's time to end it.
She's able to work, able to participate in many things (the things SHE wants to do, I'm sure) but isn't able to let you rub your dick between her well lubed thighs? Wear something sexy and talk dirty while you jerk off? Give you a hand job, for heaven's sake? Right.
You are married to, at best, a child, and more likely a selfish bitch. dump her and find an adult while you still have time.
One thought about this man's wife- I wonder what sort of health condition she has? He mentions that she functions normally as to work but is in pain a lot. Some sort of chronic condition it seems? Here's the thought- nobody has mentioned depression, that I noticed.. there's clear and strong associations with chronic illness, pain and depression. Have they ever thought about getting help with that aspect of it? (ie antidepressants- they can also help with chronic pain conditions). Another thought- how much does the man pitch in at home? If she's able to 'function normally " ie go to work but has chronic illness and pain... it is very likely she has spent her day's energy quota by the time she gets home. If she's the primary house=keeper.. that would not help much. The more he pitches in.. the more energy she might have for other things.
Sorry, no magic bullets but ... this situation as described by Dan sounded a bit one-dimensional to me. There's always more to every situation... more things to look at than the obvious. If someone is chronically ill and in pain... sex may or may not ever be on the table, but trying OTHER things rather than dealing with sexual situation directly.. well, it could help.
Also, great advice from Kim and EricaP.
Difficult conversations are difficult, and they often invoke strong emotions. But adults need to power through them to get resolution. From the letter, it's not clear who isn't being the adult here.
On the other hand, I doubt this will work in practice. That is an answer that should have come up after two years or at most ten. If something like that was going to work, it was going to work long ago.
She cries and accuses him of wanting to leave her because she knows that is the logical end of this situation. He should leave her, she knows it, and she tries to preempt it by immediately going there when they discuss the problem. She goes to the ultimate step as a way of avoiding any of the intermediate steps.
I don't agree with Dan that cheating is the answer in this situation though. She is not going to tolerate it, and even in a no fault state he is likely to get screwed in the division of property one way or another. It will also poison their relationship. I know that sounds odd to think of when I am advocating divorce, but is possible that they can go on being friends after divorce if there is no betrayal during the marriage. People do manage that. He probably would like to maintain some relationship with someone who he has been close to for half his life. That won't be possible once she catches him cheating on her.
Tl;dr: Do divorce her, don't cheat on her
Likewise, I think he's trying to differentiate the monogamous from the monogamists. The monogamous are those who are in that sort of relationship because it works for them and they see it as the best option. Monogamists are those who think that this option is the only workable one and that any degree of openess in the marriage is immoral, will lead to marital chaos, is the sign of a marriage in decline etc. That is to say, a monogamist is a monogamous person who sees strict monogamy as the only acceptable relationship type. @27 is a monogamist, people saying "well I'm monogamous but I can see where this situation may be different" are not.
Since lack of information have never stopped me in the past, I shall give it a go. The options:
1. Stay with marriage. Don't cheat. Be miserable.
2. Stay with marriage. Cheat. Manage potential cheater anxiety/STD's. Possibly be less miserable.
3. Talk about it, tears be damned, with or without a therapist. Maybe better, maybe end of marriage.
4. Divorce, no discussion.
Knowing full well we were not given the full story, I say start with #3. You have to be able to have the tough conversations, I think, if you want some sort of fulfilling relationship. I would say, insist she discuss it, again. If she declines, or if the discussion does not alter the situation, then consider options 1, 2 and 4.
This situation sucks.
"not to the point where she’s not able to work or do many normal activities" makes it sound like the issue's more psychological (or even a psychosomatic illness) than physical.
He needs to lay it all out for her, like he did in this letter, and give her a little time to think it over. Then if she still won't discuss it, or won't compromise in some way, he needs to leave. A partner's illness is not a shackle. It's generous of him to stay with her out of concern, but it's not fair to anyone. It sounds like she can take care of herself, so it's not like he'd be leaving her to die.
And one more thought.. often when there is an ill spouse and the other is a caregiver, the caregiver gets burned out/ exhausted and has little libido also. Not hearing that here.. hm.
Wondering how much he helps her with daily tasks. One commenter was brilliant- said she'd dealt with chronic illness and had little energy at the end of her workday. Rather than discussing sex sex sex.. maybe they could discuss instead how to decrease her responsibilities to give her body a break. That could boost health, mood, energy (and tada, libido.. ) more than anything I can think of.
I love Dan's column but I think he kind of blew it here, perhaps cos he was a bit fixated on the whole monogamy issue. I think this couple has a bigger problem, personally...
I am too. Plus, I've had periods of chronic pain/depression before and sex usually *alleviates* pain and unhappiness, and helps renew the bond of your relationship-all good things. Plus this guy sounds like someone who would be GGG and would really care about doing it right.
I can't really think of an illness where you can work and do normal actvities, but can't have sex. I mean, it's not for us to judge, I guess, whether her claim is valid, but it sounds like perhaps this is just an excuse-which means it's extra shitty and manipulative. He's buying that explanation, but maybe he shouldn't.
Therefore, clarifying question--while a touching meditation on this anonymous and unknowable individual--are rather beside the point.
I am in a monogamous marriage, for what it's worth, and I would rather eat glass than let my relationship fall apart. If I or my spouse weren't satisfied with any aspect of our relationship, I would hope that we would commit to fixing it, whatever it took, even if it meant relinquishing monogamy. Or maybe just getting separate bathrooms (no marriage is perfect).
"she becomes very defensive and will typically cry and say that she fears that I'll leave her."
Then, instead of being patient and supportive when she starts to cry and freak out about you leaving her, tell her the truth: that without a resolution, you just might.
In my opinion, honesty is the best way to go about this sort of thing, as long as it's possible. It sounds like he's tried everything but a very hard truth, and a very hard conversation, because when he has, she's stopped that conversation with tears and fears. It's entirely possible that working past those fears will not only open up new options in their relationship, but might remove some of the negative stigma she has been feeling about sex, a stigma that has probably grown the more it's talked about and made her less interested in having it, even on her pain-free days.
However, from his email it appears he has brought up the subject multiple times. Even if he backed off a little too early each time, the fact he didn't entirely drop the matter should indicate to her it's something that requires discussion. Her failure to address it is indeed a failure. It sounds like she's content to suppress the topic.
If a man in this situation goes outside his marriage and finds a young, healthy woman who likes sex, and likes having it with him, he'd be a fucking fool to stay in the marriage, no matter how "committed" he is or how guilty he feels for ditching a chronically ill spouse.
So why even suggest cheating? Cheating will only result in divorce under these circumstances. The ONLY benefit to cheating is that he'll have his new girlfriend/living situation already lined up before he's served with divorce papers.
Time to lay the cards on the table. "I understand that you have fears and issues with regards to me getting my sexual needs met. But I can't live my life this way. I want to stay married to you. If you are unable/unwilling to continue the sexual part of our marriage, then we need to work this out in order to stay married. Your need for no sex is being met. My need for sex is not. That situation is not equitable and cannot continue. What I would like is for us to agree on boundaries and parameters - i.e., I have sex only with partners you approve, I only perform certain acts and not others, I only have sex with a given person x number of times - whatever will work to ease your insecurity about this. I love you and want to stay with you, but you are torturing me."
Dump this woman if you love her. She will never meet your needs and you are only delaying the inevitable end. I'm sorry for your awful situation, but many have been where you are, and have left their spouses to remain sane and try to find happiness.
Our culture is hopelessly sex-negative, as many comments above indicate. The sooner a person understands themselves enough to know if sex is a want or a need, all cards need to go on the table, and more suitable mates should be found.
Divorce. Don't cheat.