The Role of Consent in the Context of BDSM

Cara R. Dunkley1 and Lori A. Brotto

Abstract

Consent represents a central focus in the controversial realm of BDSM—an overlapping acronym referring to the practices of Bondage and Discipline, Dominance and Submission, and Sadism and Masochism. Many authors have argued that the hallmark feature that distinguishes BDSM activity from abuse and psychopathology is the presence of mutual informed consent of all those involved. This review examines the relevant literature on consent in BDSM, including discussions on safety precautions, consent violations, North American laws pertaining to BDSM practice, and the role of the BDSM community with respect to education and etiquette surrounding consent. Practical information relevant to professionals who work toward the prevention of sexual exploitation and abuse is provided. The explicit approach to consent practiced by those in the BDSM community is proposed as a model for discussions around consent in clinical and educational contexts. Criteria for distinguishing abuse from BDSM and identifying abuse within BDSM relationships are outlined. It is our hope to demystify the consent process and add to the growing body of literature that destigmatizes consensual BDSM practices.

Keywords

BDSM, consent, sexual safety, sexual coercion, sexual sadism

BDSM—an overlapping acronym referring to the practices of Bondage and Discipline, Dominance and Submission, and Sadism and Masochism—has garnered increased attention in recent years. Consent represents a central focus in the controversial realm of BDSM. Authors have argued that the hallmark feature distinguishing BDSM fromabuse and psychopathology is consent (Connolly, 2006; Newmahr, 2011; Ortmann & Sprott, 2012; Taylor & Ussher, 2001). The practice of mutually defined and agreedupon behaviors is said to be primary qualities that delineate BDSM from coercive sex (Cross & Matheson, 2006; Martin, Smith, & Quirk, 2016; M. S. Weinberg, Williams, & Moser, 1984; Yost, 2010). With this in mind, consent violations happen within the context of BDSM. This article aims to review the literature and laws concerning consent in the practice of consensual sadomasochism (SM). The parameters of consent with respect to BDSM are discussed. Safety precautions outlining how informed consent is obtained and maintained before, during, and after a scene are considered. The gray area of consent and potential for confusion are explored, drawing from North American laws and relevant research. Most of the studies discussed in this article recruit from local BDSM communities and are thus limited to people who identify as BDSM community members. The following review must be interpreted with the knowledge that BDSM practitioners who volunteer for research may be more psychologically well adjusted than those who do not, and thus may not be representative of BDSM practitioners as a whole. It is also possible that people who practice BDSM behaviors without full consent or in harmful ways may provide untruthful responses, or not self-select to participate in research. The limitations of self-report, such as questionable honesty of responses and the problems associated with face-valid measures, must be kept in mind for many of the studies discussed. Social desirability of responses represents a problem for most self-report-based psychological research, but may be especially pertinent to BDSM practitioners, who often face stigma. The researchers who study BDSM tend to be advocates of BDSM, which may influence the nature of research questions pursued, the choice of whether or not to publish results, as well as introduce potential biases, such as experimenter effects. It is also possible that studies with unfavorable findings on BDSM are more prone to “the filedrawer effect” due to the sex-positive political climate adopted by most human sexuality journals.

History of Pathologizing Paraphilia

Despite increased awareness, there are many misconceptions surrounding consensual BDSM practice. These misconceptions can be traced back to early theorists’ conceptualization of sadomasochistic behavior as perverse and pathological (see Freud, 1938; Krafft-Ebing, 1886), a viewpoint that may have stemmed from the fact that most sadomasochistic individuals examined in early literature were drawn from clinical or forensic populations. Such writings perpetuated the assumption that involvement in BDSM reflects symptoms of underlying psychopathology, regardless of the concerns for safety and consent (Connolly, 2006), and heavily influenced diagnostic classification systems. In recent decades, however, the growing body of literature on contemporary SM suggests that the early theories and diagnostic systems failed to accurately capture the lived experience of modern BDSM practitioners.

    Krueger (2010, 2011) reviewed the empirical literature from 1900-2008 on the paraphilias of sexual masochism and sexual sadism in preparation for changesplanned for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013). Numerous studies demonstrate that BDSM practitioners are largely indistinguishable from nonpractitioners in terms of psychopathology (e.g., Connolly, 2006; Cross & Matheson, 2006; Richters, De Visser, Rissel, Grulich, & Smith, 2008; T. S. Weinberg, 2006). Krueger concluded that Sexual Masochism and Sexual Sadism should be retained in the DSM-5, noting that while sadomasochistic behavior is relatively common and is associated with good psychological and social functioning, there is a minority of sadomasochists who present with serious injuries or death during activities, and that such cases are pathological. Nonetheless, a large population of BDSM practitioners do not meet the DSM-5 criteria (R. B. Krueger, 2010, 2011) and, as such, should be clearly differentiated. The DSM-5 introduced a distinction between nonpathological paraphilic interests and paraphilic disorders. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; APA, 2000), there was no term to indicate nonpathological, atypical sexual interests. The DSM-5 redefined the term paraphilia so that it describes a persistent, intense, atypical sexual arousal pattern, independent of whether it is the source of impairment or distress, which would not be considered disordered. The DSM-5 uses the term paraphilic disorder to describe a paraphilia that is accompanied by clinically significant distress or impairment. The classifications of Sexual Sadism and Sexual Masochism were meaningfully changed to Sexual Sadism Disorder and Sexual Masochism Disorder, respectively, to reflect this differentiation. This distinction specifies that a paraphilia is a “non-normative sexual preference” but not inherently a mental disorder, and that a diagnosis of a paraphilic disorder requires that one’s sadism or masochism must either involve a nonconsenting person or cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning” (APA, 2013, p. 695). To qualify for a diagnosis, an individual must experience personal distress about their paraphilia, not merely distress resulting from society’s disapproval. This represents an important caveat, as it is not uncommon for BDSM practitioners to experience distress resulting from their interests conflicting with societal standards (Wright, 2006, 2010). Unfortunately, the decades long interpretation of the term paraphilia, which typically implied the presence of psychopathology, may continue to create confusion. This distinction, we argue, is paramount to identifying the practice of consensual BDSM, and to how BDSM clients are met in a therapeutic setting. A new iteration of the International Classification of Diseases, Eleventh Revision (ICD-11, World Health Organization, 2018), deleted the diagnostic categories that consist of consensual or solitary sexual behavior entirely, including consensual SM. Sexual Sadism has been replaced with coercive sexual sadism disorder.

Prevalence

Research indicates that a substantial minority of people in the general population engage in or fantasize about BDSM activities. A national study of sexual practices conducted in the United States on 2,800 respondents revealed that approximately 14%of men and 11% women had participated in some form of BDSM behavior (Janus & Janus, 1993). Moser and Kleinplatz (2006) reviewed multiple studies that surveyed BDSM and estimated that 10% of adults in the general population have engaged in some form of BDSM activity. In a sample of 1,040 adults, Joyal and Carpentier (2017) found 19.2% of men and 27.8% of women to endorse desire to experience some form of masochism, while 9.5% of men and 5.1% of women endorsed a desire to experience some form of sadism. In the same study, 13.9% of men and 23.7% of women reported experiencing at least one lifetime act of masochism, and 7.4% of men and 3.9% of women reported experiencing sadism. Holvoet and colleagues (2017) surveyed 1,027 Flemish adults from a market research and polling agency, and found that 12.5% indicated regularly performing at least one BDSM-related activity. Of the participants in this study, 26% endorsed seeing themselves as being interested in BDSM, and 7.6% self-identified as BDSM practitioners.

Definitions of Consensual BDSM

Several authors have offered definitions for consensual BDSM. Wiseman (1996) defined SM as “the knowing use of psychological dominance and submission and/or physical bondage, and/or pain, and/or related practices in a safe, legal, consensual manner for the participants to experience erotic arousal” (p. 10). Townsend (1983) described six characteristics that embody a BDSM scene,1 namely, power exchange in the form of dominance and submission, the infliction and reception of painful stimuli that is experienced as pleasurable by those involved, the use of role play or fantasy, some form of humiliation or degradation of the submissive partner, the incorporation of fetishistic elements, and ritualistic activities. Weinberg et al. (1984) identified five common features of sadomasochistic activities: the appearance that one partner controls the other, role play, consensuality, shared beliefs about what constitutes SM, and a sexual context. A qualitative study attempting to define SM found four main “definitional discourses” that reflect the way self-identified BDSM practitioners define SM, including consensuality, an unequal balance of power, sexual arousal, and compatibility of definition (Taylor & Ussher, 2001). Moser and Kleinplatz (2007) added to these lists of commonalities, noting that sadomasochistic interactions and relationships begin with negotiation and discussion of limits. Although BDSM comprises vast and varied activities, the explicit informed consent of all those involved represents the most prevalent characteristic of BDSM (Connolly, 2006; Pitagora, 2013; Taylor & Ussher, 2001; Yost, 2010).