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FOXSexpert: Autoerotic Asphyxiation: Dabbling with Death

Was it suicide, murder, or a sex game gone wrong? This is the question Bangkok police are asking in the death of 72-year-old actor David Carradine. With his naked body found in a hotel closet, one rope tied around his neck, another around his genitals, one Thai forensic scientist suggested accidental suffocation during autoerotic asphyxiation may have been the cause of death.

Regardless of whether this was the actual cause of Carradine’s death, it does bring attention to this potentially deadly form of sex play.

Also known as scarfing or terminal sex, erotic asphyxiation involves temporarily cutting off one’s oxygen supply to heighten sexual sensations during climax. The potential price to be paid for such breath play is serious, as in death and brain damage. Naturally, one has to ask: Who would dare dabble with death in achieving sexual satisfaction? And why?

Practitioners say it makes for a much more intense orgasm. The people who engage in such activity feel like they're having a thrilling "high" while having sex with themselves. For couples, the power play, role playing, and trust components are a turn on — they love the feeling of being dominated, and the comfort of being with someone with whom they feel safe.

While it should go without saying, it can’t be stressed enough — this is one sex act you want to steer clear of. There is no “safe” way to restrict blood flow. While you can try to minimize the risks in making the practices involved “safer,” there is no way that suffocation or strangulation does not put an individual at risk of cardiac arrest.

Should this occur, the chance of resuscitation is slight, even with the best of help. Cutting off blood supply to the brain can induce cerebral anoxia, oxygen deficiency to the brain, resulting in death or tissue damage.

By the Numbers

The number of people who engage in erotic asphyxiation of any kind is unknown. Barely any research has been conducted on the subject. Yet we do know that masturbation gone wrong results in several deaths every year. An estimated 500-1,000 Americans, mostly 12- to 25-year-old males, are thought to die from autoerotic asphyxiation annually.

Yet these deaths aren’t typically reported as sexual misadventures. Instead, with the individual often found hanging from a doorknob or closet rod, they’re reported as suicides. This is in part thanks to mortified parents altering the death scene before paramedics arrive. In any case, friends and family are left confused and defending the deceased, who gave no indication of being depressed or into “kinky” sex.

It’s hard to fathom the turn-on of solo or partnered asphyxiation, even when you consider that the throat has long been a fascinating, sensitive erotic zone. The draw of asphyxiation practices is the increased sexual excitement it offers. The lightheadedness and exhilaration experienced supposedly heighten orgasmic sensations as well.

For some, greater sexual satisfaction is derived from the feelings of helplessness, lack of control, self-endangerment, or sense of control. Some are into the heightened fantasy, altered state of consciousness, or trust such sex invites. The giddiness and euphoria it creates has been likened to a good alcohol buzz or drug high.

While “conventional” couples are said to engage in strangling, choking, or hanging during sex, such erotic asphyxiation is more commonly used in the bondage and discipline, dominance and submission, sadism and masochism community. This type of sex play often involves one partner putting his hands around the other’s neck — at the lover’s request — and squeezing it to intensify the experience. In some cases a belt may be used. In other cases, a hand or object is placed over the nose and mouth.

As part of her dissertation research, Kathryn Ando, of the Center for Sex and Culture, found that more women are on the receiving end of such play, while men are mostly on the giving end. In her sample of 350 people, Ando also learned that the ratio of those practicing partnered breath control versus solitary breath play was about 3 to 1.

Yet when it comes to autoerotic asphyxiation, such is usually pursued by namely straight, white, middle-class young men and adolescent boys. These baggers or gaspers, as they are known, place a plastic bag (to be torn when they desperately need oxygen) over their heads during self pleasuring.

Alternatively, they may tie a rope around their neck. According to Paul Joannides, author of “Guide to Getting It On!,” up to a quarter of them don female underwear while masturbating in this way.

The danger of such arousal, no matter who the practitioner or what the situation, is twofold. You risk death or significant injury in: (1) cutting off blood to the brain; and (2) cutting off oxygen for a period of time. Add to this other dangers, including loss of consciousness, and you’ve got a recipe for disaster.

Accidental death is due to equipment failures (for example, the safety releases don’t work), errors in placement of the noose or ligature, or other mistakes that sometimes occur with the methodologies used. Death also results when one’s self-control or judgment fails.

Other risky side effects include cutting, bruising, or lacerating the neck, trachea, and esophagus. These are dependent upon the suffocation or strangulation technique employed.

And those are just the immediate hazardous side effects. Sexologists and healthcare professionals who speak out on this topic worry about the unknown, long-term consequences of cutting off your oxygen supply.

Most people don’t know just how risky erotic asphyxiation is, with practitioners often in the dark about its risks and consequences. There is a need for education around this largely hidden topic. But this is tough terrain to teach, since there are fears that education will encourage the practice.

Carradine’s death is allowing the opportunity for education, the focus of which needs to be harm reduction. The best way to go about doing this is to educate people about neck and throat care, just as you would any other part of the body. Such education would highlight significant injuries to avoid when it comes to the throat or neck.

Until such efforts are in place, it can’t be stressed enough:Don’t do this at home (or in a hotel or anywhere else for that matter). If your partner requests it, be smart and turn it down. It beats being a murder suspect. Imagine having to say, “She asked me to choke her during sex, your honor, honest.”

You see what I mean?

Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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