One of the central points of conflict within Ferguson’s novel is the concept of predestination, many aspects of which are expressed via the instinctive behaviors that arise from Mackenzie and Noah’s designations as omega and alpha, respectively. Within the context of the novel, society holds an ingrained belief that biological designations play a hand in a person’s fate and that romantic partnerships are heavily influenced by biological imperatives associated with specific designations. Ferguson reveals this implied belief in Mackenzie’s inner monologue as she tries to fake knowing what an intimate, omega-alpha relationship involves. As she says to Priya, “I’m not sure how it hasn’t occurred to me yet, the supposed compatibility between an alpha and an omega. I know from medical school that an alpha can’t even properly knot with anyone but an omega” (61). By making true sexual fulfillment a parameter of omega-alpha relationships, Ferguson constructs a narrative plot point that alludes to the biological inevitability of pairings between the two designations. 

Given these difficult realities, the characters must grapple with several intertwined dilemmas. Specifically, Noah and Mackenzie find themselves wondering whether they can mindfully choose to be in a relationship when their bodies dictate their choice for them.