Hypoxyphilia

Abstract

This is the Advisor's report on Hypoxyphilia, as it is currently called in DSM-IV, submitted at the request of the DSM-5 Paraphilias Subworkgroup of the Sexual and Gender Identity Disorders Workgroup. The background literature is reviewed together with information from the author's recent and as yet unpublished research derived from an internet survey of more than 100 living practitioners of this paraphilic activity. It is recommended that the term "asphyiophilia," already used in the literature, is preferable as there is little to indicate that the effects of oxygen deprivation per se are the primary motive for the behavior; rather, it is sexual arousal to restriction of breathing. It is properly regarded as a severe and potentially dangerous manifestation of Sexual Masochism which can result in physical harm or death and therefore should be identified as such, perhaps as a specifier. However, there is no good reason to identify it as a separate paraphilia though it should be named in the DSM-5 text as it is a well-recognized and unusual mode of death. Less severe forms of Sexual Masochism which do not threaten life or otherwise cause serious physical harm should not be regarded as mental disorders.

Injuries due to Asphyxiation and Drowning

“…This is utilised in various sexual practices, known as hypoxyphilia (Hucker 2011). As such, it is primarily men who cause pendular movements of the body to achieve a 'regulated' compression of the neck.…”

One Hundred and One Cases of Plastic Bag Suffocation in the Milan Area Between 1993 and 2013—Correlations, Circumstances, Pathological and Forensic Evidences and Literature Review

“…Autoerotic PBS is the accidental consequence of sexual practices aimed at obtaining the beginning of asphyxia to strengthen one's sexual arousal and orgasm [in this case the term “asphyxiophilia” can be used to specify a practice widespread on the Internet ].…”

Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)

“…The WGSDSH also recommended the inclusion of the category Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals to describe persistent and intense patterns of atypical sexual arousal—manifested by sexual thoughts, fantasies, urges, and/or behaviors—that involve consenting adults or solitary behaviors, as long as either: (1) the person is markedly distressed by the nature of the arousal pattern and the distress is not simply a consequence of rejection or feared rejection of the arousal pattern by others or (2) the nature of the paraphilic behavior involves significant risk of injury or death (e.g., asphyxophilia or achieving sexual arousal by restriction of breathing) (Hucker, 2011). The requirement of excluding distress caused by rejection or feared rejection of the arousal pattern by others has been included to help protect against misuse of this paraphilic disorder category based on social stigmatization alone.…”