The dilemma can be between two supposedly good options, such as, "Would you rather get intimate with the person on your left or right?", or it can be between two supposedly bad options, as in, "Would you rather sleep with your best friend's lover or your lover's best friend?"
The players, sometimes including the questioner, then must choose their answers. Answering "neither" or "both" is against the rules. This leads the players to debate their rationales.