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IntroductionThe past years BDSM (an acronym for bondage and discipline, dominance and submission, and sadism and masochism) has gained a significant amount of attention and popularity in the general population, portraying an inaccurate image of BDSM and the people who share these interests. Yet despite this increasing popularity, only little empirical research has focused on this subject and it’s possible driving mechanisms so far, sustaining the existing misconceptions and stigma towards BDSM in general and BDSM practitioners in specific.ObjectivesWe aimed to gain more insights on understanding the underlying psychological mechanisms, such as sensation seeking and coping, in people who participate in BDSM-related activities, as well as into the factors which contribute to the existing stigma and discriminationMethodsIn a national survey study 256 Dutch-speaking BDSM-practitioners were compared to a matched sample of people from the general Belgian population (N = 300) who lack any interest in BDSM in two separate studies.ResultsAbout 86% of the general population maintained stigmatizing beliefs about these sexual interests and practices. In regard to sensation seeking and coping, compared to controls, BDSM practitioners reported signifcantly higher levels of sensation seeking for all dimensions, as well as the use of more active coping skills.ConclusionsPeople who do not conform to the current social standards of our society often seem to remain the subject of stigmatization and discrimination. Further research is needed to explore the psychological processes that drive BDSM interests in order to destigmatize and normalize consensual BDSM-related activities.DisclosureNo significant relationships.

BDSM is a type of sexual preference that includes bondage and discipline, dominance and submission, and sadism and masochism. Research has identified three specific power exchange roles in the practice of BDSM: dominance, submission, and switch. It has also been suggested that attachment style potentially influences BDSM interests. This study investigated the potential roles of attachment style in driving BDSM identity. A questionnaire was completed by a cross-sectional Chinese sample ( n  = 3310, age range 18–30 years), including 1856 BDSM practitioners (436 men, 1420 women). To assess attachment style, the questionnaire included a Chinese translation of the Adult Attachment Scale as well as items surveying BDSM interests. Compared to non-BDSM practitioners, attachment styles were not significantly different from BDSM practitioners. However, practitioners with different BDSM identities showed a significant difference in their attachment styles. Secure and avoidant attachment styles were associated with dominance, whereas submissiveness recorded high average scores of separation anxiety in both males and females. BDSM identities based on gender revealed that 60.5% of female practitioners assumed the role of submissiveness and this group recorded the highest average scores of separation anxiety among all groups. These results show that BDSM identity is related to attachment style. However, the results did not support the hypothesis that attachment styles potentially drive BDSM identities. Further research is needed to explore other psychological processes that drive BDSM identities in order to provide guidance for BDSM practitioners in choosing suitable identities, thereby helping practitioners to choose suitable identity partners and avoid negative experiences during BDSM participation.

IntroductionBDSM is an acronym describing bondage & discipline, dominance & submission and sadism & masochism. Afflicting or receiving pain is usually an important part of the BDSM interaction.ObjectivesThis research focuses on better understanding the aspect of pain within a BDSM interaction by investigating the differences in 1) baseline pain thresholds, 2) the impact of a BDSM interaction on those thresholds and 3) threshold moderating factors like pain cognition between submissive and dominant BDSM participants and control individuals.MethodsSubmissive and dominant counterparts of 35 couples were recruited to participate in a BDSM interaction, of which 34 dominants and 33 submissives were included in analyses. A non-BDSM interested control group (n=27) was included to control for social interaction, of which 24 were included in analyses. Pain threshold measurements were measured at three points in time and pain cognitions scales were taken.ResultsBDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control group.ConclusionsThis study helps shed further light on the biological processes behind a BDSM interaction through pain threshold measurements. By enhancing our understanding of the mechanisms behind a BDSM interaction in this way, we aspire to relieve the stigma these practitioners still endure.DisclosureNo significant relationships.

IntroductionThough BDSM interest (bondage & discipline, dominance & submission and sadism & masochism) has proven to be quite prevalent (46.8% in recent research), there is still significant stigma surrounding it, both in general society and among mental health practitioners.ObjectivesThis research explores the biological mechanisms associated with a BDSM interaction in the hope to strengthen the argument that it does not belong in the psychiatric field.MethodsThe present study collected data on peripheral hormone levels, pain thresholds and pain cognitions before and after a BDSM interaction and compared these results to a control group.Resultsshow that submissives have increased cortisol and endocannabinoid levels due to the BDSM interaction and that these increases are linked. Dominants showed a significant increase in endocannabinoids associated with power play but not with pain play. BDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control groupConclusionsEven though this is one of the first studies of its kind, several biological processes can be associated with BDSM interactions, strengthening the hypothesis of BDSM as a healthy form of intimacy and promoting its distinction from paraphilias as they are described in the DSM or ICD classifications.DisclosureNo significant relationships.

Choking/strangulation during sex is prevalent among young adults, with one study finding that 58% of women college students had ever been choked during sex. However, no qualitative study has examined women’s experiences with choking/strangulation during sex outside of intimate partner violence. The purpose of our qualitative interview study was to investigate women’s experiences with choking and/or being choked during partnered sex. Through in-depth interviews with 24 undergraduate and graduate women students ages 18 to 33, we sought to understand how women communicate about choking, their learning about and initiation into choking, their feelings about being choked and choking others, as well as consent and safety practices used in relation to choking. We found that women had first learned about choking through diverse sources including pornography, erotic stories, magazines, social media, friends, and partners. While all 24 women had been choked during sex, only 13 of 24 had ever choked a partner. They described having engaged in choking with men as well as women and with committed as well as more casual partner types. Participants described consensual and non-consensual choking experiences. While many women enjoyed choking, others did it largely to please their sexual partner. Women described different methods and intensities of having been choked. Although very few had ever sought out information on safety practices or risk reduction, and only some had established safe words or safe gestures with partners, participants consistently expressed a belief that the ways in which they and their partner(s) engaged in choking were safe.

Using data from an undergraduate probability sample, we aimed to: (1) describe the prevalence and demographic characteristics of students who reported having engaged in rough sex with their current partner; (2) assess which sexual behaviors students consider to be rough sex; (3) describe the frequency with which participants report engaging in rough sex as well as their reports of initiating and liking rough sex, in relation to gender and sexual identity; and (4) examine predictors of rough sex frequency. Participants were 4998 students randomly sampled from a large Midwestern university who completed a confidential Internet-based survey (2453 women, 2445 men, 41 gender non-binary, 36 transgender or other gender non-conforming identities). Within these, 1795 individuals who reported a romantic/sexual partner of at least 3 months responded to questions about engaging, liking, and initiating rough sex. The most common behaviors participants considered to be rough sex were choking, hair pulling, and spanking. Transgender and gender non-binary students more often endorsed behaviors as rough sex. Also, rough sex was conceptualized as multidimensional, with one cluster being more consistent with earlier conceptualizations of rough sex (e.g., hair pulling, spanking) and the second cluster including behaviors such as choking, slapping, punching, and making someone have sex. About 80% of those with a current sexual or romantic partner engaged in rough sex with them and most who engaged it liked it. Bisexual women reported greater rough sex frequency and enjoyment (54.1% indicated enjoying it “very much”). Implications for sexuality research and education are discussed.

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one’s sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature.

Despite a recent increase in academic attention, little is known about how the general population perceives BDSM practitioners. Though the gay/lesbian community has undergone de-medicalization and de-stigmatization over time, the same process for BDSM practitioners is in its infancy. Past research suggests that BDSM practitioners do expect to be stigmatized by others, especially in the healthcare system; however, little is known about how the general population currently perceives and stigmatizes the BDSM community. In the current study, we found that the general population ( N  = 257) does stigmatize BDSM practitioners more than the gay/lesbian population, and both are stigmatized more than a low-stigma comparison group (people in romantic relationships), F (2, 253) = 21.70, p  < .001, η 2 = 0.15. These findings help to inform mental healthcare providers and the general population about BDSM practitioners, with the goal of inspiring additional research and activism aimed at combating misinformation and reducing stigma toward this population.

Sexual choking has become increasingly normalized among young people, largely driven by media, pornography, and peer norms. Although often framed as consensual, breath‐control practices are physiologically unpredictable and can cause rapid loss of consciousness, brain injury, or even death within seconds. Once consciousness is lost, consent cannot be given or verified. Clinical and forensic experience in Finland indicates that choking is frequently reported in younger patients, yet national prevalence data are lacking. We argue that sexual choking is never medically safe, that clinicians should routinely ask about it, assess for injury, and provide clear risk counseling, and that medical ethics require engagement with harmful trends in patient care. Further research is needed to quantify prevalence and harms in Finland. Sexual choking is increasingly normalized among young people yet is never medically safe; loss of consciousness can occur within seconds, making consent impossible to verify. Clinicians should routinely ask about choking, assess injuries, and counsel patients against breath‐control practices.

Prior limited research on entrance into BDSM divided paths of entry into external or internal factors (Yosta & Hunter, 2012 ), while research on age at entry into BDSM has not considered variation by BDSM role identity, gender, sexual orientation, and other demographic differences. In this mixed-methods exploratory study, we contribute to this literature by collecting and analyzing qualitative interviews with 96 self-described practitioners of BDSM to more fully describe distinct pathways into BDSM, adding nuance to prior descriptions of entry. We also collected and analyzed surveys with 2,017 self-described practitioners of BDSM to examine patterns of age at entry into BDSM practices and fantasies, and selection into older or younger age at practice and age at fantasy by BDSM role identity, gender, sexual orientation, and other demographic characteristics. Interview respondents told “constructionist sexual stories” describing introductions to BDSM via popular culture including pornography and other media, the Internet, or a sexual partner that awaked an inherent interest, along with “essentialist sexual stories” which described self-discovery solely attributed to an inherent personality characteristic. Survey data revealed that age at fantasy and onset of behavior varied by social–environmental factors. Pathways and patterns into BDSM behavior and fantasies therefore reflect a combination of idiosyncratic interests, exposure to ideas via the media or partners, and stratified social norms and opportunities related to sexual behavior.