How safe is BDSM? A literature review on fatal outcome in BDSM play

Schori, Anouk; Jackowski, Christian; Schön, Corinna A.

doi:10.1007/s00414-021-02674-0

Cited by 21 publications

(15 citation statements)

References 31 publications

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“…Given its prevalence and frequency, sexual choking may be the most common form of choking/strangulation in the U.S., and it disproportionately impacts women. Yet, aside from case reports and media articles describing unintentional death from consensual sexual choking (e.g., Roma et al, 2013;Schori et al, 2022;Zemek, 2021), and one study demonstrating a cross-sectional relationship between a history of having been choked and poorer mental health (Herbenick et al, 2022a), little is known about potential health sequelae from being choked during sex. Building on prior research related to strangulation in other contexts, a goal of the present study was to characterize sexual choking, how it is enacted, and the physical responses people notice from having been choked.…”

Section: Physical Responses Of Choking/strangulationmentioning

confidence: 99%

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Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Herbenick

Eastman-Mueller

et al. 2022

Arch Sex Behav

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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.

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Section: Physical Responses Of Choking/strangulationmentioning

confidence: 99%

“…A recent review of fatal outcomes in BDSM found that strangulation accounted for most of the reported fatalities (Schori et al, 2022). Most people will have insufficient training to attend to someone should they lose consciousness, experience a seizure or cardiac arrest, or become unresponsive while being choked.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Herbenick

Eastman-Mueller

et al. 2022

Arch Sex Behav

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“…Consequently, what people tend to refer to as sexual choking may share at least some health risks as those arising from strangulation occurring in other contexts, such as the so-called “choking game,” sexual assault, or intimate partner violence (IPV) (Bichard et al, 2022 ; Busse et al, 2015 ). These risks may include neck bruising, neck edema, recurrent headaches, tinnitus, alterations in consciousness, and—in rare cases—death (Herbenick et al, 2022a ; Schori et al, 2022 ). In this paper, we use the term sexual choking to refer to strangulation that occurs during sex.…”

Section: Introductionmentioning

confidence: 99%

“…While fatalities from consensual sexual choking/strangulation are rare, they do occur (Schori et al, 2022 ) and have been documented since at least the 1700s (Tarr, 2016 ). A recent review of deaths from partnered bondage and discipline/dominance and submission/sadism and masochism (BDSM) practices found that most case reports (88%) resulted from manual or ligature strangulation (Schori et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

#ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex

et al. 2022

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Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s10508-022-02502-5.

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“…Strangulation, even with non-fatal intentions, carries inherent health risks. For example, strangulation was identified as the most common cause of death in Bondage, Discipline, Dominance, Submission, Sadism, and Masochism (BDSM)-related fatalities in a literature review of case reports from 1986 to 2020 (Schori et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

Huibregtse

Alexander

Klemsz

et al. 2022

Front. Behav. Neurosci.

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Being strangled, or “choked,” by a sexual partner has emerged as a prevalent, often wanted and consensual sexual behavior among adolescent and young adult women, yet the neurological consequences of repeated exposure to this behavior are unknown. The objective of the study was to examine the association between a history of repeated, recent choking/strangling episodes during sex and fMRI activation during working memory tasks in young adult women. This case-control study involved young adult women (18–30 years old) at a large, public university, and consisted of two study groups: a choking group consisting of participants who were recently and frequently choked/strangled during sex by a partner (≥4 times in the past 30 days) and a choking-naïve (control) group who had never been choked/strangled during sex. Participants completed two variations of the N-back (0-back, 1-back, and 2-back) working memory task during functional magnetic resonance imaging (fMRI): verbal and visual N-back tasks. Data from 20 participants per group were available for analysis. Between-group differences for accuracy and reaction time were not significant for either variation of the N-back task. Significant differences in fMRI activation patterns were detected between the choking and the choking-naïve groups for the three contrasts of interest (1-back > 0-back, 2-back > 0-back, and 2-back > 1-back). The choking group exhibited increased activation in multiple clusters relative to the choking-naïve group for the contrasts between the 1-back and 2-back conditions compared to the 0-back conditions (e.g., superior frontal gyrus, corpus callosum). However, the choking-naïve group exhibited increased activation relative to the choking group in several clusters for the 2-back > 1 back contrast (e.g., splenium, middle frontal gyrus). These data indicate that recent, frequent exposure to partnered sexual strangulation is associated with different neural activation patterns during verbal and visual working memory tasks compared to controls, suggesting that being choked/strangled during sex may modify the allocation of neural resources at increasing levels of cognitive load. Further investigation into the neurologic effects of this sexual behavior is warranted, given the prevalence of sexual choking among adolescent and young adult women.

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How safe is BDSM? A literature review on fatal outcome in BDSM play

Cited by 21 publications

References 31 publications

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

#ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

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