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updated 8/25/2009 1:06:11 PM ET 2009-08-25T17:06:11

Q. I know that I am a lesbian. I dream of being with a woman. However, I am married with one child. I love my husband, and I believe he knows in his heart I am gay.

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I don’t love having sex with my husband, but I do what I must in order to make him happy. I struggle with what I am doing. But our life is so good and comfortable, why change it?

A. It is your choice as to whether it’s worth denying your sexuality because of the comfortable state of your marriage.

Your note is timely. The American Psychological Association recently released a report stating that mental-health professionals should not tell people their sexual orientation can be changed by means of therapy or other such interventions.

So, if you are a homosexual, no amount of therapy, thinking, wishing or hoping is going to change this.

Despite your knowledge of your orientation, however, you have married a man and clearly enjoy having a family life with him. This is actually more common than you think.

What you are missing is sexual fulfillment, and so is your husband. It is highly likely he is aware of this. At the very least, he must know he doesn’t have a very fulfilling love life, mainly because he isn’t truly desired by you.

I don’t know what you mean by believing “he knows in his heart” that you are gay. I take it to mean that he knows you are not sexually attracted to him, but that you have never specifically disclosed your sexual orientation to him, or discussed it.

So, I would ask you: Do you know whether your husband is happy, or are you guessing? How happy is he? What is the nature of this happiness? Is he happy he has a family and lives with someone he likes a lot? Or is his life tinged with unhappiness because this woman he desires does not desire him back?

You may feel it is obvious you are gay, but your husband might not know for sure. If he did know, he might decide he didn’t want to be married to a woman who does not desire him physically. It is unfair of you to claim he knows in his heart when you have done nothing but give oblique hints. In other words, this is his decision to make for himself, not yours to make for him.

You say that your life is so great, and yet you struggle with what you are doing.

Sexual fulfillment — having a suitable mate who desires you and appeals to you — constitutes a huge part of personal life satisfaction. Are you sure about giving that up?

In an ideal world, for the sake of your child, you would remain married. It sounds as though you and your husband like each other a great deal.

Cheating on each other is a terrible solution. Any kind of infidelity brings with it enormous pain. Furthermore, this involves other people.

If your husband, who has no hope of being desired in his life unless he cheats on you, does start sleeping with someone else, he will likely develop feelings for her, especially if she likes having sex with him. If you begin having sex with women, you will also likely fall in love.

It’s possible you and your husband could split up, live near each other and co-parent successfully. That way, you would both be free to have other relationships.

Obviously, it is in your best interest not to say something outright until you are ready to hear that your husband had little if no idea and might end the marriage quickly. There is definitely a risk he would exit the marriage once you owned up to your secret feelings.

And the longer this secret continues, the more likely he will feel angry and betrayed that you kept it hidden for so long. If you wait to tell him until your child is out of college or you are both elderly, it robs him of the chance to seek somebody who loves him in the way he wants to be loved. You rob yourself of the same chance.

If your current life is so valuable to you that you are willing to forgo sexual fulfillment, that is your prerogative. If you are not sure you can find someone else to really love you, or if it is more important to keep your family life intact, those are also choices you and your husband should make together.

There is nothing wrong with deciding you will trade one important aspect of your life for another. People do this all the time. They move far from their families for educational opportunities, or they choose a secure job over an exciting one, or they endure a mediocre job that pays well.

You might be willing to give up a fulfilling sexual life for the comfortable family life you have. Your husband might also be willing. But both of you should really consider that your own sexual happiness and fulfillment is no small matter in terms of being content with your lives.

It’s fine to make this decision, as long as you know what you are giving up and what you are gaining in return, and as long as you are being honest with both yourself and your spouse. But it is not fair to continue misleading your husband. You might also decide to re-evaluate your decision in the future.

Dr. Gail’s Bottom Line: People often sacrifice some life priorities for the sake of others. This includes deciding that other aspects of life are more important than sexual fulfillment and romantic love.

Any ideas, suggestions in this column are not intended as a substitute for consulting your physician or mental health professional. All matters regarding emotional and mental health should be supervised by a personal professional. The author shall not be responsible or liable for any loss, injury or damage arising from any information or suggestion in this column.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her most recent book is “The Ripple Effect: How Better Sex Can Lead to a Better Life” (Rodale). For more information, please visit www.drgailsaltz.com.

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