Throughout the play, the themes of sex and death are intricately connected. From the outset, Booth’s gun stands as a symbol of what critic Margaret B. Wilkerson describes as his "sexual potency," which might be more imagined than actual. Booth is always armed, with his gun loaded and ready, reflecting how he views himself in relation to women; he is perpetually seeking sexual encounters. Additionally, Booth comments on how the arcade shooters fire blanks, using this to mock Lincoln about the sexual impotence that contributed to his divorce from Cookie. The interplay of sex and death emerges again when Booth assists Lincoln in rehearsing his dying scene to enhance his performance and secure his job. Booth tells Lincoln to scream during the death scene but then criticizes him for sounding as if he is having sex.

Sex takes on a destructive role when Ma asks her Thursday Man for money to address a problem. He refuses, leaving Ma to deal with her pregnancy alone. It's uncertain whether she kept the baby or chose to terminate the pregnancy, highlighting how sex, typically a life-giving force, can also lead to death. Moreover, Ma and Pa’s continued sexual indiscretions ultimately lead to the downfall of their family. The play’s most poignant reference to sex and death occurs when Booth reveals that he "popped" Grace. While the term popped has sexual undertones, Booth uses it to describe shooting Grace because she refused his sexual advances.