Erotic Asphyxiation

Breath play, also known as auto-erotic asphyxiation or choking, can take many forms. It’s not only dangerous but, if performed incorrectly, it can be a form of sexual assault.

This case report demonstrates the importance of clinicians being aware of this sexually motivated practice. It is the first reported case of nontraumatic orbital subperiosteal hemorrhage associated with this behavior.

Physiological Reasons

Erotic asphyxiation, also known as breath play or erotic choking, is a sadomasochistic fetish of consensual strangulation during sexual activity. It is said to enhance sexual arousal and intensify orgasm. This fetish can involve using a rope, cord, belt, scarf, necklace, or plastic wrap to choke one or more partners. It is often combined with sex toys such as a vibrator or cock, and may be done for pleasure or as punishment.

Autoerotic asphyxiation, in which individuals restrict their oxygen supply to themselves, is very dangerous if the correct precautions are not taken. It can cause brain damage, hemorrhaging, and death. This fetish is not well-known and is rarely addressed in mainstream media or portrayed in pornography, making it difficult to recognize.

In addition to the physical dangers of choking, the psychological impact can be serious. It can be a source of anxiety and fear for those who engage in it. It can also lead to depression, suicidal thoughts, and anxiety disorders. In fact, some people with autoerotic asphyxiophilia report hiding their behavior from family members to avoid causing embarrassment or shame.

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Medical professionals should be aware of this fetish and educate their patients about the risks involved. They should also be ready to recognize symptoms such as a history of asphyxiation, unexplained marks on the neck or body, questionable ligature materials, and suspiciously locked doors.

Psychological Reasons

Erotic asphyxiation is popular among those who practice bondage, discipline and dominance, and is often depicted in pornography. However, it poses a high risk of accidental death and is typically more common in males.

The practice, also known as asphyxiophilia or breath control play, is characterized by the intentional restriction of oxygen to the brain for sexual arousal. Those who engage in this activity are often referred to as gaspers or breathers. The behavior is dangerous and has been linked to an estimated 250 to 1,000 deaths per year in the United States.

In the past, people interested in erotic asphyxiation have been stigmatized and shamed for their interest, leading them to pursue this practice without sufficient knowledge of safety. In addition, they often feel compelled to hide their interests from those close to them. This has resulted in a rapid spread of information, whether accurate or not, about the practice as it is increasingly shared online.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders-fifth edition) demedicalizes and destigmatizes unusual sexual behaviors, including asphyxiation, provided they do not cause distress or pose a risk to the person engaging in them. Nevertheless, this behavior is still considered a paraphilic disorder, which means that those involved may have an abnormal attraction to masochism, pain and sensations of suffocation.

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Physical Reasons

Breath play can cause permanent damage to areas like the larynx and heart. It also can lead to choking, which cuts off oxygen to the brain, leading to confusion and eventually death. It’s even more dangerous when done alone because there is no one to help. Experts estimate that between 250 and 1,000 people die each year from erotic asphyxiation.

A sadomasochistic fetish, erotic asphyxiation involves strangulation with a rope or belt around the neck to enhance sexual arousal and the intensity of orgasm. It is often depicted in pornography. It is a popular pastime among people who enjoy bondage, discipline and dominance. It is a practice that is accompanied by rituals and can become obsessive.

Although the practice is illegal in many countries, it continues to be performed. As a result, doctors must be aware of it when treating victims who have died from this form of asphyxiation. The forensic examiner must be able to distinguish it from suicide or non-fatal strangulation as well as homicidal hanging/strangulation. If it is not properly identified, the victim may be charged with murder or manslaughter. For this reason, it’s important for a physician or investigator to be familiar with the criteria of erotic asphyxiation. In addition, the forensic examiner must be able to differentiate it from other forms of accidental or suicidal death.

Legal Reasons

Erotic asphyxiation (also called asphyxiophilia, breath control play or hypoxyphilia) is the practice of intentionally restricting oxygen to one’s own body in order to experience sexual arousal. It is an increasingly popular fetish that can be dangerous for the person engaging in it, especially if the fetish involves a method of suffocation with no way out, or if they are alone. It is often used by people who engage in bondage, discipline, dominance and submission, and it has become more common because of its depiction in pornography. It is also popular among people who are drawn to the sensational, extreme or erotic.

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Breath play can be dangerous because it can restrict the airflow to the heart and larynx, causing permanent damage or even death. It is also difficult to perform correctly, as it can cause the muscles to go limp, which tightens a ligature around the neck and can ultimately lead to death. Breath play can also be hard to do if someone has a disability that causes them to be inflexible, such as muscular dystrophy or cerebral palsy.

A recent judgment from the Court of Protection in England and Wales was the first time that a court had considered assessing capacity in relation to erotic asphyxiation. The case involved a person with autism spectrum disorder who was engaged in the sexual practice of autoerotic asphyxiation and had no other means of achieving pleasure, including sex.

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