Is S&M Dangerous? Let’s Look at the Evidence

Science, technology, and life.
July 10 2013 10:50 AM

Spank You Very Much

Is S&M dangerous? Let’s look at the evidence.

Aiden is voluntarily dominated by women at a dungeon party during the domination convention.
A dungeon party at a domination convention in Los Angeles

Photo by David McNew/Getty Images

Earlier this year, I wrote two articles about BDSM—bondage, dominance/submission, and sadomasochism. I argued that BDSM, unlike homosexuality, was inherently problematic and wasn’t an orientation. Defenders of BDSM—Dan Savage, Jessica Wakeman, Clarisse Thorn, Jillian Keenan, and dozens of Slate commenters—wrote back, rejecting these arguments. Then, two months ago, Dutch psychologists published a study of kinksters and mental health. I started digging around. There isn’t much quantitative research on this population, but I found a few decent studies that can help us clarify the debate. Is BDSM sick? Let’s look at the evidence.

William Saletan William Saletan

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

1. How many people do BDSM? There’s only one good random-sample survey on this question. It was taken in Australia a decade ago. Nearly 20,000 people between the ages of 16 and 59 were interviewed by phone. In the whole sample, 1.8 percent of men and 1.2 percent of women answered yes to the question, “In the last 12 months, have you been involved in B&D or S&M?” (The question went on to explain, “That’s bondage and discipline, sadomasochism, or dominance and submission.”) Among respondents who were sexually active, the BDSM minority barely increased, to 2 percent of men and 1.4 percent of women. Among those who had a sexual partner in the previous year, the figure was 2.2 percent of men and 1.3 percent of women.

That’s roughly equivalent to the sexually active gay population, as measured by similar self-reporting. In the Australian survey, the authors reported “less than 2 per cent of men and women” said they’d “had sex with a same-sex partner in the past year.” The percentage of respondents who said they’d ever had a gay sexual experience (not just in the last year) was higher—6 percent of men, 9 percent of women—and presumably the same is true of BDSM. In the Dutch study, for instance, 448 respondents accessed and completed a BDSM survey through a website devoted to personal secrets. Of these, 3 percent “indicated having had previous BDSM experience.”

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2. Is it an orientation? Previously, I argued that homosexuality is fixed (an orientation) but that BDSM is flexible (a lifestyle). Kinksters replied that BDSM, too, is an orientation. What do the data show? Mostly flexibility. In a study of Finnish BDSM enthusiasts, 27 percent “endorsed a statement suggesting that only sadomasochistic sex could satisfy them,” but only 5 percent “no longer practiced ordinary sex.” Furthermore, 40 percent had changed their “preference” or “behavior” (in the authors’ words) from sadism to masochism or vice versa. In another study, conducted in southern California, “32% of the sample indicated that BDSM play occurred less than half the time they spent in sexual activity with partners, and just 11.2% indicated that BDSM play was their only form of sexual activity.” The core group, dedicated to BDSM, seems vastly outnumbered by dabblers.

3. Is it physically dangerous? That depends on what you’re doing. In the Finnish study, bondage and flagellation were standard: More than 80 percent of the sample had done them in the preceding 12 months. The riskier stuff was far less common:  piercing (done by 21 percent of the sample), skin branding (17 percent), hypoxyphilia (suffocation games, also known as breath play—17 percent), electric shocks (15 percent), and knives or razor blades (13 percent). The California study found a similar pattern: Bondage, flogging, and spanking were standard (more than 80 percent had done them), but other practices—“fire play” (20 percent), “piercing play” (20), cutting (14), branding (9), and scarification (5)—were rarer. Some potentially dangerous activities were surprisingly common—“electric play” (42 percent), “knife scenes” (40), and “breath play” (27)—though in many cases, the implements were probably just props. It looks as though about 20 percent of these folks are actually cutting, burning, zapping, or partially suffocating each other.

That’s a minority, but it’s still worrisome. In the Finnish sample, those who said they’d previously suffered sexual abuse—23 percent of the women, and 8 percent of the men—were particularly problematic. According to the authors, “Visits to a physician because of injuries obtained during sm-sex were significantly more common among the abused respondents (11.1%) than among the non-abused respondents (1.8%).”

BDSM community leaders preach the importance of “safe words”—prearranged signals that the restrained, flogged, or dominated participant can use to withdraw consent and stop the action. In the Finnish study, 90 percent of the sample said they “sometimes” incorporated such words in their encounters. But less than half did so “without exception.” That, too, is a problem.

4. Is it mentally unhealthy? For the most part, no. The surveys vary, so let’s take them one by one. The California study, conducted by Pamela Connolly of the California Graduate Institute, found a “significantly higher level of narcissism” in its BDSM sample than in the general population. Connolly estimated that 30 percent of people in the sample were clinically significant on that scale. Theoretically, a high narcissism score implied “little interest in give-and-take in social life,” but Connolly cautioned that it could signify “personality strengths as well as personality pathology.” Only two of the 132 participants met the criteria for pathological narcissism, and Connolly noted an “absence of borderline pathology.”

Likewise, the sample “scored relatively highly on almost all of the scales” related to dissociative symptoms, suggesting a “higher prevalence of a dissociative syndrome.” Yet only one respondent met the criteria for dissociative identity disorder. Compared with the general population, the sample showed a “significantly higher level of histrionic features,” which increased the risk of “fear of genuine autonomy,” “a need for repeated signs of acceptance and approval,” and an “indiscriminate search for stimulation and affection.” But Connolly added that this result might have been skewed by geography, since the Los Angeles BDSM community favored and fostered exhibitionism.

Connolly reported no significant differences on “most measures of PTSD, on obsessive-compulsion or on depression or anxiety.” She emphasized that “no evidence was found to support the notion that clinical disorders—including depression, anxiety, and obsessive-compulsion—are more prevalent” in the BDSM population.

A Canadian study published that same year (2006) also defended BDSM. “Masochists were not found to be more prone to psychological distress or mental instability than the other groups,” the authors wrote, and “we found no support for the idea that masochists were more inclined to engage in escapist behaviors such as drug-taking.” Furthermore, “the SM participants scored equivalent to or lower than the non-SM comparison group on Authoritarianism.” But the authors conceded that their small sample—93 people—made it statistically difficult to find differences.

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