This study utilized an exploratory descriptive design to examine the perceptions of 11 individuals that participate in public performances of bondage and sadomasochism (BDSM). The sample consisted of 7 males and 4 females from age 23 to 50 years old. The study analyzed respondents’ answers to a semi-structured interview guide that was developed by the researcher. Qualitative content analysis indicated several themes relevant to participant’s subjective experiences with BDSM: incidence and frequency of practice in BDSM activities were addressed; safety concerns and self-perceived satisfaction were addressed; social stigma, stereotypes, and disclosure surrounding this population were examined. Gender roles and the feminist theory were also discussed in reference to practitioners of BDSM.

Lamarche, S. L. (2006). An exploratory study: Factors associated with persons who perform sadomasochistic acts in public.

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Many forms of sexual behavior are poorly understood by large sectors of society. Some physicians may be unaware of their patients’ sexual activities or may feel ill at ease discussing them. Provided with a basic knowledge of these activities and their associated slang terms, a physician can better communicate with the patient, allowing for accurate and thorough diagnosis, treatment, and ongoing care.

Moser, C. (2006). Demystifying alternative sexual behaviors. Sexuality, Reproduction and Menopause, 4(2), 86-90.

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This paper examines slash fan fiction’s contributions to BDSM discourses and symbolism. BDSM is culturally delegitimated as a sexual pathology, and protest against it highlights broad concerns about sexual consent within patriarchy while also misdirecting unease about sexual coercion onto the ritualized and eroticized exchange of power rather than social systems of domination. Contrasting the BDSM classic The Story of O with The Story of Obi, a Star Wars–based slash rewrite, facilitates a conceptual separation between erotic domination and the historical and cultural contexts that give shape to individual enunciations of sexualized power exchange, particularly by shifting from a psychoanalytic paradigm to consideration of chivalric “suffering for love.” By calling upon the extensive shared knowledge of fan readers and the symbolism attached to the sexual conjunction of two same-sexed bodies, authors of slash fan fiction produce a constantly proliferating array of BDSM representations that challenge the speciation of erotic domination as an inherently destructive, unidirectional deadlock. They thus create unique narrative and semiotic tools for rethinking erotic uses of power.

Kustriz, A. (2008). Painful pleasures: Sacrifice, consent, and the resignification of BDSM symbolism in “The Story of O” and “The Story of Obi”. Transformative Works and Cultures, 1,

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Assessing pathological from non-pathological expressions of alternative sexuality requires close connections between research, clinical practice, and professional training. Stigmatization of various forms of sexuality can cause significant difficulties in gaining information from and making observations about people with alternative sexualities. The present investigation employed a content analysis approach to stories and reflections expressed by 32 heterosexual couples who practice consensual erotic BDSM (bondage/discipline, dominance/submission, sadism/masochism), and their experiences in therapy. Five main categories emerged: Termination Of Therapy, Prejudice, Neutral Interactions, Knowledgeable Interactions, and Non-Disclosure Of BDSM Sexuality. This analysis highlights, from the point of view of the client, the importance of treating a disclosure of BDSM sexuality as only one of several possibly important factors about the client during the therapeutic interaction. Also important to effective therapeutic interaction is to avoid automatically communicating about BDSM sexuality from a cultural model of “BDSM is sickness/pathology” or “BDSM is immoral/wrong” but to discern whether the client’s activities fit the alt-sex community standard of “safe, sane, and consensual.”

Hoff, G. (2009). Therapy experiences of clients with BDSM sexualities: Listening to a stigmatized sexuality.Electronic Journal of Human Sexuality, 12.

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This paper discusses lessons about sexuality and eroticism gleaned from those who engage in extraordinary sex, even though such relationships have typically been classified as pathological. What can clinicians learn from those who seek and attain uncommon sexual relations? Such individuals’ sexual epistemology, goals, understanding of the nature and spectrum of sexual and erotic relations, communication strategies and “outcome” criteria can provide valuable lessons for those who treat sexual problems or aim to overcome sexual mediocrity. For example, while traditional sex therapy often focuses on what is on the surface, some SM participants are interested in the meanings that lie at a deeper level. Whereas conventional clinicians may focus on enabling particular sexual acts (especially heterosexual intercourse), SM participants are more apt to be concerned with the varied spectrum of underlying purposes motivating these acts. Whereas many couples are willing to settle for merely functional sex, SM practitioners may be more interested in contact that necessitates intense, erotic connection; sophisticated communication of subtle differences in intent; and eventuates in profound self-knowledge and transcendent levels of intimacy. Illustrative case examples are provided.

Kleinplatz, P. J. (2006). Learning from extraordinary lovers: Lessons from the edge. Journal of Homosexuality, 2/3, 325-248.

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People whose sexual repertoire includes BDSM, fetish, or other “kinky” practices have become increasingly visible, on the Internet, in the real world, and in psychotherapists’ offices. Unfortunately, the prevailing psychiatric view of BDSM remains a negative one: These sexual practices are usually considered paraphilias, i.e., de facto evidence of pathology. A different, affirming view of BDSM is taken in this paper. After defining BDSM and reviewing common misconceptions, a variety of issues the practitioner will face are described. These include problems of countertransference, of working with people with newly emerging sexual identities, working with spouses and partners, and discriminating between abuse and sexual “play.”

Nichols, N. (2006). Psychotherapeutic issues with “kinky” clients: Clinical problems, yours and theirs. Journal of Homosexuality, 2/3, 281-300.

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SM International

No abstract available.

(2006). SM international. Journal of Homosexuality, 2/3, 263-280.


In this article we discuss psychiatric diagnoses of sexual deviation as they appear in the International Classification of Diseases (ICD-10) the internationally accepted classification and diagnostic system of the World Health Organization (WHO). Namely, we discuss the background of three diagnostic categories: Fetishism (F65.0), Fetishistic Transvestism (F65.1), and Sadomasochism (F65.5). Pertinent background issues regarding the above categories are followed by a critique of the usefulness of diagnosing these phenomena today. Specifically, we argue that Fetishism, Fetishistic Transvestism, and Sadomasochism, also labeled Paraphiliaor perversion should not be considered illnesses. Finally, we present the efforts of an initiative known as ReviseF65 which was established in 1997, to abolish these diagnoses.

Reiersøl, O., & Skeid, S. (2006). The ICD diagnoses of fetishism and sadomasochism. Journal of Homosexuality, 2/3, 243-262.

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This article describes a child custody case centered on the fitness of the mother, who was involved in an SM relationship with her live-in boyfriend. Although the investigation confirmed that no child abuse had occurred, that the child was unaware of the mother’s sexual interests, that there were no incidents of inappropriate sexual activities in front of the minor, and that the child was doing well, the court severely limited the mother’s visitation and custody arrangements and ended her alimony. Practitioners of alternative sexual lifestyles have not fared well in child custody hearings, and this case is no exception. The present case indicates how the family court system can be biased against sexual minorities in general and SM practitioners in particular. In addition, the present case demonstrates how the DSMdiagnostic criteria can be misused in dealing with alternative lifestyle practitioners. Recommendations for further education of the court and for future research are made.

Klein, M., & Moser, C. (2006). SM (Sadomasochistic) interests as an issue in a child custody proceeding. Journal of Homosexuality, 2/3, 233-242.

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This paper reviews the origin of the concept of sadomasochism and its treatment by the American legal system. Relevant court cases and corollary issues such as the rights to privacy and sexual freedom, child custody, domestic violence, and employment discrimination are profiled. Organizations created by the gay, lesbian and heterosexual leather communities to create accurate public awareness of the SM subculture, and their programs of education and activism, are discussed and prospects for effective legislative change evaluated.

Ridinger, R. J. (2006). Negotiating limits. Journal of Homosexuality, 2/3, 189-216

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