For gay men, open relationships aren’t unusual, but the arrangements vary. But just because something is common doesn’t mean it’s right for everyone. When a couple in a troubled relationship considers opening up the relationship as a way to fix their problems, an alarm sounds for me, and I often discourage them from doing so. But partners who are basically healthy as individuals and stable as a couple may benefit from an open relationship. Even in our highly sexualized society, alternative arrangements such as open relationships may seem alien and intimidating to many people, but as therapists, our challenge is to be less prudish and frightened by potentially negative outcomes.