Dr. Larch is a secret abortionist who has seen firsthand how sex workers and other poor vulnerable women are treated. His youthful experience with a sex worker led him indirectly to his work. The sex worker later sought him out when he was a doctor, seeking help after a self-induced abortion; he was unable to save her, or later her daughter, who wanted him to give her a safe abortion.

Many other characters in the novel are similarly motivated by sex and secrecy. Homer and Melony have secret sexual encounters at the orphanage, and Homer is later sexually assaulted by Grace Lynch, a worker at the orchard, who is herself regularly assaulted by her husband. He tells no one about this assault, both because it causes him shame and because he does not have the language to describe it. Later still, he has an affair with Candy Kendall, the girlfriend of his friend Wally. When he tries to confront Mr. Rose about his secret abuse of his daughter, Mr. Rose intimates to Homer that he knows about he and Candy’s affair, so as to keep Homer in line. He does this in an almost wordless way, simply showing Homer the candle nub left over from Homer’s recent encounter with Candy in the cider house and asking, “That ‘gainst the rules, ain’t it?” (551).