Content Warning: This section discusses rape and sexual assault.

Dark romance is a controversial genre that mixes themes and elements from thrillers, suspense, and horror with narrative tropes and techniques from the romance genre. Where romance generally focuses on characters meeting and falling in love in idyllic or romanticized settings, dark romance presents relationships where at least one of the participants exhibits problematic or immoral traits, and there are often undercurrents of trauma, violence, or sexual violence. In dark romance novels, characters’ relationships usually unfold in a contextual setting that is meant to disturb or unsettle the reader. Some dark romance works incorporate supernatural or paranormal elements, blending in distinct aspects of horror to enhance the setting in which the romance builds. Carlton is known for her work in dark romance, which is often seen as pushing the boundaries of what is acceptable in the genre; her novel includes instances of dubious consent, violence, and rape. For example, in Carlton’s book Haunting Adeline, the male romantic lead stalks the titular character and similarly features sexual assault and coercion.

Does It Hurt? follows Carlton’s pattern of including morally gray characters that follow an “enemies to lovers” narrative.