The Biology of BDSM: A Systematic Review

Abstract

Introduction BDSM is an abbreviation used to reference the concepts of bondage and discipline, dominance and submission, sadism and masochism, enacted by power exchanges between consensual partners. In recent years, attention has shifted from the idea of BDSM as a pathological and tabooed niche practice towards viewing BDSM as a healthy form of intimacy. Aim This systematic review brings together all existing literature on the biology of BDSM and places it in a broader biological context. Methods A systematic search was conducted on PubMed, Web of Science and PsycARTICLES, of which 10 articles are included and discussed in this systematic review. Results There is evidence for cortisol changes in submissives as a result of a BDSM interaction, suggesting involvement of the physiological stress system. Endocannabinoid changes implicate the pleasure and reward system. In dominants, this biologically measured pleasure seemed to be dependent on power play rather than pain play. Testosterone and oxytocin are also implicated in BDSM, though their role is less evident. Research into brain region activity patterns related to BDSM interest suggests a role for the parietal operculum and ventral striatum in the context of the pleasure and reward system, the primary and secondary somatosensory cortex in the context of pain perception, empathy-related circuits such as the anterior insula, anterior midcingulate cortex and sensorimotor cortex and the left frontal cortex in the context of social and sexual interactions. Pain thresholds are shown to be higher in submissive individuals and a BDSM interaction may cause pain thresholds to rise in submissives as well. Conclusion BDSM interactions are complex and influenced by several psychological, social and biological processes. Though research is limited, there is emerging evidence for an interaction between several biological systems involved in these types of interests and activities. This means there is an important role for future research to replicate and supplement current results.

An Evolutionary Psychological Approach Toward BDSM Interest and Behavior

“…Thus, to perpetuate BDSM as pathological, when it is indeed a healthy form of intimacy for many (Wuyts & Morrens, 2022 ; Wuyts et al, 2020 ), can have harmful consequences in the therapeutic context. In such cases, it is possible that an erroneous association of kink or sexual fetishism with compulsion is partly to blame.…”

“…De Neef et al ( 2019 ) as well as Wuyts and Morrens ( 2022 ) have systematically reviewed studies that have uncovered biological processes behind BDSM. Both reviews identified and discussed evidence related to hormonal and neurological workings involved in BDSM practice, mainly during and post-BDSM play.…”

“…The researchers suggested that this incongruence between attraction and practice could be a result of the disruptive effects that Toxoplasma can have on dopaminergic pathways in the host’s brain, which could reduce the individual’s novelty-seeking attributes and thus, translate to less engagement in BDSM activities. Toxoplasmosis is also associated with higher testosterone levels in males (Borráz-León et al, 2021 ), and while testosterone is implicated in sexual motivations and social dominance, its link to dominance in the BDSM context remains unconfirmed (Wuyts & Morrens, 2022 ).…”

Tickle fetishism: pleasure beyond playfulness

“…This relationship underscores the intricate connection between tickle fetishism and BDSM, contributing to the complexity of tickling experiences within the broader framework of sexual behavior. Despite valuable insights into the biology of BDSM, including brain activation and hormonal changes ( Wuyts and Morrens, 2021 ), existing literature lacks a comprehensive understanding on tickle fetishism. Tickling fetishism shows an overlap with other fetishes, including foot fetishism (podophilia), suggesting potential connections between these various sexual preferences ( Provine, 2012 ).…”

How does sexual deviance develop?

“…Nondelinquent participants with pedophilia may display rather normal neurobiology (Krüger & Kneer, 2021;van Kessel et al, 2022). A recent meta-analysis of the biology of BDSM concluded that during BDSM interactions, brain systems regarding reward (for both dominants and submissives) and pain and stress (for submissives) were involved (Wuyts & Morrens, 2022). Yet, their etiological account remains unclear.…”