ArticlePDF Available

Demystifying alternative sexual behaviors

Authors:
  • Diverse Sexualities Research and Education Institute

Abstract

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.
CHARLES MOSER, MD, PhD
Sexuality, Reproduction & Menopause VOL. 4, NO. 2, OCTOBER 2006
Patients are often reluctant to discuss
or even acknowledge the specific sex-
ual activities in which they engage.
These activities often have medical
consequences or provide important clues to
other diagnoses. Discussion of these acts is
hampered further by a lack of vocabulary and
knowledge of what these sexual behaviors en-
tail. Patients may perceive physicians as unin-
formed or judgmental of alternative sexual ac-
tivities. Therefore, the tolerant and educated
physician’s initiation of a conversation con-
cerning sexual matters creates an environ-
ment where the patient feels safe to disclose
information that may benefit his or her care.
Some guidelines on approaches to opening
such conversations follow and basic descrip-
tions of associated slang are also provided.
Bringing up sex
Not every practitioner is comfortable dis-
cussing sexual issues. For them, referral is an
appropriate option. Those practitioners who
feel at ease having these discussions may
choose to become a resource for their local
medical community. The general medical care
of practitioners of unusual sex behavior is in-
cluded in the new medical specialty of Sexual
Medicine.
Before meeting the physician, the patient
will gauge his or her openness to discussing
sexual issues by the manner of the office staff
and the intake forms. These will influence the
patient’s decision to disclose his or her sexual
practices. An important first step for the prac-
titioner is to make your intake forms sympa-
thetic to a spectrum of sexual activities. At the
very least, these forms should allow patients
to indicate with whom they have sex (men,
women, both, or neither) and their own pre-
ferred gender identity (male, female, trans-
sexual, intersex, or other). Individuals do not
necessarily define themselves by the sex of
their sexual partners, so it is best to avoid terms
like homosexual, heterosexual, and bisexual.
Similarly, some people choose not to define
their gender as dictated by their genitals or
chromosomes. Common courtesy is to refer
to the patient in the manner of their choosing.
During the review of systems, consider
adding just three words: “Any sexual con-
cerns?” This phrase is deliberately broad and
open-ended. To elicit a more specific re-
sponse, the practitioner might add, “Do you
have any medical questions about any of the
86
CHARLES MOSER, MD, PhD
Demystifying alternative
sexual behaviors
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.
Charles Moser, MD, PhD,
FACP
Professor and Chair
Department of Sexual Medicine
Institute for Advanced Study
of Human Sexuality
San Francisco, CA
© 2006 American Society
for Reproductive Medicine
Published by Elsevier Inc.
KEY POINTS
There is a lack of awareness among physicians concerning alternative
sexual behavior.
Sexual Medicine Physicians treat the medical aspects of sexual concerns
and the sexual aspects of medical concerns, which include the general
medical care of practitioners of alternative sexual behavior. They have a
clear and comfortable understanding of sexual practices and terms.
By providing a comfortable and sympathetic clinical environment, a
physician encourages the patient to be open and honest. This can help
the physician provide the best diagnosis and treatment.
While alternative sexual practices may result in injury, it is important that
the physician be able to distinguish these from those injuries received in
an instance of abuse.
Demystifying alternative sexual behavior
VOL. 4, NO. 2, OCTOBER 2006 Sexuality, Reproduction & Menopause
sexual activities in which you engage?” Some
physicians make a statement such as, “Sex is
often difficult to discuss even with a physician,
but I want you to know that I am open to your
questions.”
The individual who arrives at the emer-
gency room with an object in his or her rec-
tum is always asked how this occurred. The
answer rarely falters: “I slipped in the show-
er.” The important question is rather, “Was the
activity consensual?” Your ability to obtain the
answer to that question is compromised even
by asking the first naive question. If the mech-
anism is important, then explain why it is im-
portant to obtain the needed information.
It is important not to guess or assume too
much. Patients can feel violated if they think
their appearance or manner suggests their
hidden sexual desires. Prefacing the question
with an explanation of the medical importance
of the information tends to increase their
comfort level. Some considerations to keep in
mind when expanding one’s practice to incor-
porate Sexual Medicine are included in the
box titled, “Some general rules for discussing
unusual sexual acts” on this page.
“Unusual” sex acts
Unusual is in quotations because these sexual
interests are not really unusual. Although re-
search data on their incidence and prevalence
are not available, in practice there are rela-
tively few patients (or physicians), who do not
engage in some sexual act that others would
view as unusual.
The range of human sexual behavior is so
broad, that this article can only touch upon
some interests. It has been said that anything
and everything can be eroticized. Why would
someone enjoy X or find Y erotic? The answer
is the same reason you find whatever it is that
you find erotic, erotic. How humans develop
any sexual interest is a basic and unanswered
question in psychiatry and sexology.
General terms
Sexual minorities (everyone but the tradi-
tionally heterosexual) may call themselves or
their activities queer, perv, pervert, kink,
kinky, or fetish. Those who are not sexual
minorities are called vanilla or straight; vanil-
la is also used to describe non-kink sexual
activities. To be squicked is to be personally
upset or disgusted by a given behavior, but
does not imply a judgment that the behavior
is wrong for others.
Someone who is coming out (exploring
the activity or beginning to accept the identi-
ty) is called a novice or newbie. Someone who
loves sex is called a slut. Sometimes a specific
type of sex or activity is particularly desired,
eg, pain slut, fuck slut, rope slut, or anal slut.
Sexual interactions are called play, but direct
genital stimulation is not necessary.
Individuals who wish to live or pass as
members of the other sex are TG (transgen-
dered). Those that want SRS (sex reassign-
ment surgery) are TS (transsexual). MTFs
(male-to-female TS or TG) call themselves
trans or transwomen to distinguish themselves
from natal women, also called GGs (genuine
girls) or fish. FTMs are female-to-male TSs
(the TG/TS distinction is not clear in this
group) and may call themselves transmen. A
man who is erotically aroused by dressing as a
woman is a TV (transvestite), some of whom
will become trans. Drag queens are gay men
who dress as women, but more for theater
than gender dysphoria. She-males (a type of
TG MTF) are interested in male sex partners
and are expected to get an erection and use
their penis during sex. Drag kings, lesbians
who dress as men, also exist.
Anal
Stimulation of the anus/rectum is called ass
play. Butt plugs (objects used for anal inser-
tions) are held in the rectum by the anal mus-
culature and can be used during sex or worn
for longer periods of time. Anal beads are de-
vices for anal insertion consisting of a series of
87
Some general rules for discussing
unusual sexual acts
• Use understandable, common terms, but resist using slang or
repeating back the patient’s own terms. The patient may say
that her cunt hurts, but you would respond with questions
about her pelvic or vaginal pain. This is an opportunity to ed-
ucate. Slang terms can have different meanings or pejorative
implications when used by someone outside the patient’s
community. In most situations, you will be misunderstood!
• Do not assume that someone’s stated sexual orientation lim-
its his/her sexual activities. Some lesbians do have sex with
men. Gay men can have a male wife, a female wife, or both.
• The definitions of slang terms are seriously debated within
sexual minority communities and vary from place to place,
subgroup to subgroup, and over time.
During
the
review of
systems,
consider
adding just
three words:
“Any sexual
concerns?”
Demystifying alternative sexual behavior
Sexuality, Reproduction & Menopause VOL. 4, NO. 2, OCTOBER 2006
beads connected by a string or molded plastic
which are inserted into the rectum and
pushed in and pulled out the anus. The mix of
fecal matter and lubricant, a common result
of ass play, is santorum.
Patients may prepare for ass play by
douching (a series of enemas). Various sub-
stances (wine, other alcoholic spirits, coffee,
and illicit substances) can be added to the
enema solution, resulting in a very rapid and
powerful drug effect.
Analingus or rimming involves oral stim-
ulation of the anus. Felching is when one part-
ner sucks the ejaculate out of the anus or vagi-
na of the other partner. Snowballing is when
the ejaculate (from either fellatio or coitus) is
passed from the mouth of one partner to the
mouth of the other partner. Anal intercourse
followed by fellatio of the inserter (without
washing) is called licking clean, ATM or A2M
(ass to mouth), and is more common than you
think. Inserting an entire hand into either the
vagina or rectum is called hand balling, fist-
ing, or fist-fucking. Practitioners of these be-
haviors often cut their fingernails exceeding-
ly short to prevent any inadvertent lacerations,
which can be a clue to the behavior found on
physical exam.
A dildo (artificial phallus) or strap-on can
be used for vaginal or anal insertions; it is not
uncommon for them to be referred as the
owner’s cock. A strap-on is a dildo, worn in a
harness that allows one to engage in coitus
with one’s partner regardless of anatomy or
sexual dysfunction.
BDSM
BDSM is an acronym for Bondage and Disci-
pline (B&D), Dominance and Submission
(D/S), and Sadism and Masochism (SM or
S&M); it describes people (players) who eroti-
cize bondage, a power differential, physical,
or psychological pain (sometimes called in-
tensity). BDSM play is called a scene. Leather
can be a fetish object and is also synonym for
BDSM, especially Gay BDSM.
Players who take the active role are called
dominant, dom, domme, domina, top, master,
mistress, and sadist. Players who take the pas-
sive role are called submissive, sub, subbie,
bottom, masochist, boy or girl, and slave. (In
some SM interactions, it may not be immedi-
ately obvious which partner identifies as the
top and which as the bottom, although the
practitioner may feel strongly about the label.)
Switches can take either role.
There is intense debate concerning the
distinctions among these terms; for example,
someone may say “I am a masochist; I will be
submissive if my partner enjoys it, but I am no
one’s slave.” Simplistically, a masochist prima-
rily seeks physical sensations. The submissive
primarily enjoys the psychological aspects, but
maintains options to control the intensity and
duration of the scene. The slave wishes to
serve and/or give up as much control as pos-
sible. Other sexual minorities use the term
bottom to describe the one penetrated or the
receiver of the intensity or play, without im-
plying a BDSM relationship. Similarly, a top
is the one who penetrates or applies the in-
tensity.
Mixed play implies a BDSM interaction
between people who would not usually have
sex together (a gay man with a lesbian, for
example). BDSM partners engage in negotia-
tion, the process of agreeing on what will con-
stitute the specifics of their scene. They de-
cide upon a safe word (a word or gesture that
will stop the scene), and mutually define the
limits (activities not to be included in the
scene). Violating someone’s limits is a serious
faux pas.
Toys are small items used during sex, in
contrast to large items called equipment
(slings, tables, bondage furniture). Toys in-
clude whips, handcuffs, vibrators, cock rings
(a leather, metal, rubber or latex ring tightly
cinched at the base of the penis to prevent de-
tumescence, which actually works), rope,
chains, violet wand (i.e., a device with a pur-
plish glow using static electricity to stimulate
the body), and chastity belts (devices that pre-
vent someone from stimulating themselves,
achieving an erection, or engaging in coitus).
There are other toys that limit some sen-
sory input (blindfolds) or prevent individuals
from speaking (gags) or closing their mouths.
Hoods may have zippers or snaps, allowing the
attachment of objects or blocking the mouth
or nose. Padded bits, blinders, and bridles are
88
Ioften have individuals consult with me, simply
to discuss the safety of a particular behavior,
the possible medical problems that could occur,
and how to avoid them.
Demystifying alternative sexual behavior
VOL. 4, NO. 2, OCTOBER 2006 Sexuality, Reproduction & Menopause
used during pony-play (i.e., role-playing being
a pony).
People who want to incorporate BDSM
into their lifestyle are 24/7 (24 hours a day, 7
days a week); a more intense form of this is
called TPE (total power exchange). Those
who only engage in SM during sexual interac-
tions do EPE (erotic power exchange) or
“keep it in the bedroom”. Players usually ad-
here to the SSC (safe, sane and consensual)
creed, though some people frame it as RACK
(Risk Aware Consensual Kink). Consensual
non-consent is a conscious, negotiated sus-
pension of one’s limits. A play party is a social
gathering where semi-public BDSM activities
take place; the party space (venue) provides
equipment and usually DM’s (dungeon mon-
itors, individuals who assure compliance with
SSC and other party rules). Players usually
bring their own toys. First date scenes often
take place at a party as additional safety.
Some individuals especially enjoy play in-
volving a specific area of the body, e.g., tit tor-
ture, CBT (cock-and-ball torture), and cunt
torture. Edge play (i.e., activities that tend to
squick people) require more experience to en-
gage in safely. These activities are not inher-
ently abusive, criminal or self-destructive.
They are typically loving, intimate and well-
thought-out in terms of safety.
BDSM play often results in skin redness,
bruising, or welts. Some recipients like these
marks and wear them as a badge of honor;
others dislike them. Some people engage in
play piercing, temporary placement of hypo-
dermic needles in the skin. These can also
leave distinctive marks. Scrotal or labial infla-
tion (insuffulation with sterile saline) can be
the cause of subcutaneous emphysema.
Gay subcultures
Men interested in bears (big, barrel-chested
and usually bearded men) are called cubs,
though it is not uncommon to see two bears
together. Men attracted to men with large
penises are called size queens; men attracted
to Asian men are called rice queens. Daddy/
boy or boi role-plays imply a BDSM relation-
ship; the same terms can be used by women.
Women who are interested in sex with
other women are lesbians or dykes. High
femme or lipstick lesbians are women who ap-
pear stereotypically feminine (lipstick, make-
up, high heels, frilly clothes, etc.). Femme
women also have a decidedly feminine ap-
pearance, but not to the extreme. Soft butch
women appear more androgynous. Stone
butch women tend to be masculine in ap-
pearance and may dislike any vaginal pene-
tration themselves. Femme/butch couples
exist, but other pairings are not unusual.
Men who like lesbians are called dyke
daddies, but sometimes this term is used in-
stead to mean butch lesbians. Heterosexual
women who like gay men are called fag hags
or fruit flies, but these terms do not usually
imply sexual interaction. Some lesbians will
interact erotically with gay men and/or in gay
male environments.
Alternative relationships
When your partner is aware that you have or
could have more than one partner, you have
an open relationship. Many open relationships
have a designated S.O. (significant other) or
primary partner; other relationships are called
secondary or fuck buddies. Those who are
open to more than one primary relationship
are called poly or polyamorous. Fluid-bonded
describes a relationship in which safer sex pre-
cautions are not used with that partner or
partners, but are mandatory with other part-
ners. Swingers are male-female couples who
seek others primarily for sex. Although many
89
When to intervene
Physicians are often concerned that a patient may be involved
in an abusive relationship. In a BDSM relationship, where the
results of the behavior may appear similar to abuse, it is easy to
confuse a loving consensual BDSM relationship with an abu-
sive one. Just because patients inform you that they are in a
BDSM relationship does not mean that it is not an abusive re-
lationship as well. Just because patients deny participating in a
BDSM relationship does not mean they were abused. Some of
the physical differences are:
• BDSM rarely results in facial bruising or marks that are re-
ceived on the forearms (defensive marks).
• Marks obtained during a BDSM scene usually have a pattern
and are well-defined, indicating the submissive partner re-
mained still. In abuse, the marks are more random and the
soft-tissue bruising rarely focused in one area.
• The common areas for BDSM stimulation are the buttocks,
thighs, upper back, breasts, or the genitals. The fleshy parts
of the body can be stimulated intensely and pleasurably.
Marks involving the lower back, bony areas, eyes, and ears
are unusual.
Demystifying alternative sexual behavior
Sexuality, Reproduction & Menopause VOL. 4, NO. 2, OCTOBER 2006
swingers are polyamorous and vice versa, each
is often quite dismissive of the other’s lifestyle.
Cucks or cuckholds are men who want to see
or know that their wife or girlfriend is having
sex with other men.
Gay male group sex often occurs at the
baths or a bathhouse. These often contain
glory holes – a hole cut in a partition through
which they can engage in anonymous sex.
Venues for swinging or group sex are called
sex clubs. Female-only sex clubs also exist but
are less common.
Medical complaints
Despite the common belief that unusual sex-
ual behavior often leads to injury, this has not
been my experience. A review of the Emer-
gency Medicine literature does not reveal spe-
cific problems resulting from unusual sexual
acts. STIs (sexually transmitted infections) can
be the outcome of any sex act, but in my ex-
perience these are no more likely than what is
observed among vanillas. I see many more in-
juries related to the travel to and from the sex
party than injuries received at the sex party.
Nonetheless, individuals left in bondage
too long can develop a neuropathy from nerve
compression. More important is to warn your
patients who have neuropathy not to aggravate
the injury with bondage. Some patients are
well aware of the possible consequences of
their sexual activities and use a variety of
strategies to minimize the risk; others are ei-
ther unaware of the potential problems or the
strategies for minimizing them. Few physi-
cians or other medically trained individuals
discuss the safety issues of a particular activi-
ty with patients. I often have individuals con-
sult with me, simply to discuss the safety of a
particular behavior, the possible medical prob-
lems that could occur, and how to avoid them.
Safety is an important issue at lay conferences
where these behaviors are discussed, but they
rarely involve health care personnel. In my ex-
perience, there are more kinky individuals
who have first aid and CPR training than those
in the general public.
Most of the advice given is an extrapola-
tion from other disorders. For example, there
may be an entity called Flogger’s Shoulder, re-
sulting from repeatedly swinging a flogger (a
device similar to a cat-of-nine tails). The eval-
uation and treatment of this entity is no dif-
ferent than other shoulder injuries.
Differences in types and areas of bruising
or marks can indicate whether the relationship
is abusive or not. (See box title, “When to in-
tervene” on preceding page.)
Conclusion
Sexual behavior is as diverse as one can imag-
ine. As stated, anything can be eroticized.
While a physician’s personal opinions of alter-
native sexual behavior are legitimate, the im-
position of those beliefs is not; the medical
practitioner’s primary responsibility is the
health and care of his or her patients. A range
of descriptions of terms and practices affords
the reader a level of comfort with potentially
difficult material. With this information as a
launching pad, a physician is equipped to
begin the discussion of sex with the patient; in
turn, the patient will likely feel relief at the op-
portunity to be open, and to receive the best
treatment.
90
Charles Moser, MD, PhD,
FACP
Professor and Chair
Department of Sexual Medicine
Institute for Advanced Study
of Human Sexuality
45 Castro Street, #125
San Francisco, CA 94114
Docx2@ix.netcom.com
Resources
Gay and Lesbian
Medical Association
www.glma.org
Harry Benjamin International
Gender Dysphoria Associations
(organization for health care providers
who work with TGs and TSs)
www.hbigda.org
National Coalition
for Sexual Freedom
(includes the Kink-Aware
Professionals list)
www.ncsfreedom.org
Polyamory Support Site
www.polychromatic.com
Bisexuality-Aware Professionals
www.bizone.org/bap
Moser, C. (1999). Health care without
shame. San Francisco: Greenery Press.
It is important not to guess or assume too much.
Patients can feel violated if they think their
appearance or manner suggests their hidden
sexual desires.
... For example, forbidden play (Salen & Zimmerman, 2004) refers to taboobreaking child's play, where as high ris leisure activities are discussed with the term, edgework (Lyng, 1990). Other such terms include deep play (Geertz, 1972), bad play (Myers, 2010), edgeplay (Moser, 2006), unplaying (Flanagan, 2009), and dirty play (Fine, 1986). Currently the terms gaining most traction in game studies are dark play (see Mortensen, Brown & Linderoth, 2018) and transgressive play (Jørgensen & Karlsen 2018). ...
... [a]lthough research data on their incidence and prevalence are not available, in practice there are relatively few patients (or physicians), who do not engage in some sexual act that others would view as unusual. 24 In ways useful for screenwriting, this suggests paradigmatic framings for the Feiticeiro/a character that recognise that people and their activities are not different depending on their roles within the social system. ...
Book
The impetus for this volume comes from a fascination with stories about the interstices of society: stories of people who live beyond the mainstream and who do things that most others find uninterestingly odd or even distasteful. Unfortunately, such marginality is too often specularised for shock value in fiction films that emulate the ‘Jerry Springer’ or the ‘Ripleys-Believe-it-or-Not’ lineage of chat-show and documentary fare. Although undoubtedly eminently saleable, the stereotypes to which such material speaks, not to mention the material itself, often end up not merely as offensive, but more damningly as simply boring, in their refusal to acknowledge the nuances of unusual people as quirky subjectivities playing in unusual contexts. If professional screenwriters are to be aided in constructing characters as more than merely superficially shocking people who do ‘weird’ things, mechanisms should be found to approach character construction in a different way. It seems self-evident (albeit not incontrovertible) from a post-anthropocentric, non-binary perspective that such characters are best phrased in terms of existential meaning and phenomenal experience.i In the context of films about sexuality it seems similarly self-evident that these characters should at the same time refuse simple replications of the stereotypes that have arbitrarily sedimented in popular consciousness from historic precedents formed by dominant conservative discourses. Unfortunately, such a framing as an antidote to narrative vacuity is not easily distillable from the most obvious first port of call for interrogating characterological marginality: the wealth of film theory based in critical discourse analyses of past cinematographic representations through a focus on the medium of film. Nor is it immediately apparent in the Hollywood ‘how to’ screenwriting manuals that peddle overly simplistic renditions of the Classical mythopoetic paradigm as a solution to questions around building characters. This implies, amongst other things, an as-yet unrealised opportunity to revise the premises for the construction of ‘perverse’ characters, a construction that is perhaps most obviously comprehensible in terms of a combination of ‘character identity’ and ‘characterisation’. The volume hopes to contribute to epistemologies intended to encourage stories that avoid stereotypes, by applying to sexually ‘perverse’ characters an engagement with challenges to consensus notions of gender and sexual orientation, more than with arguments based in critical film analysis as are usually forged through forensic investigations of stereotyping discourses. In attempting to engage this enterprise, the volume is intended as a philosophically-focused teasing-out of an episteme that might productively inspire more interesting representations of transgressive sexuality in screenwriting.
... Markers for delineating BDSM from abuse include voluntariness, communication, a safeword or ability to withdraw consent, safer sex, and access to education and information about BDSM. Moser (2006) provided a list of physical indicators that help professionals discriminate between consensual BDSM and abuse. He specified that facial bruising and defensive marks on the forearms rarely result from BDSM. ...
Article
Full-text available
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.
... Physical indicators can also help distinguish consensual BDSM from abuse. Moser (2006) provides a list of physical differences between markers of abuse and BDSM for mental health professionals and physicians: (a) BDSM rarely results in facial bruising or defensive marks that are received on the forearms; (b) marks obtained during a BDSM scene usually have a pattern and are well defined, indicating that the bottom partner remained still-marks resulting from physical abuse are typically more random, and the soft-tissue bruising is unlikely to be focused in a single area; (c) the common areas for stimulation-based play are the buttocks, thighs, upper back, breasts, or the genitals (i.e., the fleshy parts of the body that can withstand intense stimulation)-marks involving the lower back, bony areas, eyes, and ears are unusual. ...
Article
Full-text available
BDSM is an overlapping acronym referring to the practices of Bondage and Discipline, Dominance and Submission, and Sadism and Masochism. This paper reviews the psychological literature on BDSM practitioners, and discusses issues concerning BDSM that are relevant to clinicians and sexual health care providers. The literature concerning the psychological health of BDSM practitioners and clinical issues in treating BDSM practitioners was exhaustively reviewed. BDSM practitioners differ minimally from the general population in terms of psychopathology. Six clinical considerations emerged: Ignoring vs. considering BDSM; Countertransference; Non-Disclosure; Cultural Competence; Closer Relationship Dynamics; BDSM, Abuse, & Pathology.
... This fails to recognise sexual diversity that encompasses a wide range of human behaviour whereby virtually anything can have erotic associations. 37 It also ignores that most heterosexual people do not have sex with either same-sex or what they see as 'unattractive' partners, which is often framed as their being 'unable' to do so, a framing that does not result in diagnoses of psychopathology since this inability conforms to heteropatriarchal norms. 38 Failing to approach 'fetishism' in the same way indicates a discursive prioritising of heteropatriarchal norms, and an a priori pathologising of all and any nonnormative behaviour. ...
Chapter
If the Feiticeiro/a as a psychologically defined and complex character is to be seen as an embodied form/structure (not substance) that exists in dialectical relationships between self, other and discursive constructions of society, a clearer indication should be made about what kinds of behaviours or actions he/she should engage in. This chapter explores how psychiatric diagnostic criteria fail to provide assistance, despite professing to authoritatively mark stable, reliable and accurate epistemic boundaries to sexual activity. The chapter thereby addresses questions of the description of actions versus the demarcation of thoughts, objects, feelings and time as invisible and abstracted notions that are virtually the opposite of what is useful for an episteme for the Feiticeiro/a. It also approaches how the diagnostic criteria codify ‘perverse’ activity in determinist terms, thereby insidiously refusing an epistemic construct of action into which is built an acknowledgement of the behaviours of the Feiticeiro/a as a complex subjectivity.
... Descriptors such as 'queer', 'perv/pervert', 'kink/kinky' are often interchangeable, which signals fractures and multiplicities, and indicates the incorporation of varied and often contradictory self-identifiers that refuse strict person/object/practice distinctions. 29 While some 'fetishists' adopt the labels of 'dominant', 'dom', 'domme', 'domina', 'master', 'mistress', or 'sadist' if they take an active role; those adopting passive roles use terms like 'submissive', 'sub', 'subbie', 'masochist', 'boy/girl', or 'slave'. Sometimes 'fetishists' change appellations, depending on the role they're adopting, or alternatively speak of themselves as a 'switch', comfortable with either role. ...
Chapter
An episteme for the Feiticeiro/a as a filmic character who is ‘perverse’ needs a form if it is to be useful to writers wanting to construct complex transgressive sexual characters. The beginnings of this framing are productively associated with the semiotic notion of ‘connotation’. This chapter explores what is meant by complexity in character construction and suggests a framing focused on character as an embodied being as a helpful starting-point for an episteme for characterological ‘perversion’. The chapter explores this as a non-foundationalist framing that transcends problematic Cartesian distinctions, concrete object materiality and woolly broad-stroke statements of a disembodied discursive constitution of social and personal experience.
Article
Rates of pornography consumption in the U.S. are high and increasing. With exploratory aims, this study addresses the questions: What is the association between pornography consumption and liking of sexual behaviors commonly depicted in pornography, and is enjoyment moderated by gender? Sexual scripts theory suggests that increased pornography consumption is associated with increased engagement in pornographic sex acts, but it does not speak to enjoyment of the acts when engaged. The current study seeks to fill that gap. Based on data collected from a larger sample of 1,883 heterosexual men and women (predominantly, 86.6%, college or university students) in the U.S., and comparing correlations between pornography consumption (frequency of use) and reported enjoyment of a range of sexual behaviors by gender using Fisher’s z transformations (α value set at <.0025), analysis revealed that pornography consumption, overall, was not significantly correlated with increased enjoyment of the sexual acts that comprise the pornographic sexual script. However, gender was a significant moderating factor in the enjoyment, specifically, of degrading and/or uncommon acts. Male respondents were significantly more likely to report enjoying these acts than their female counterparts. These findings have possible implications for consumers, educators, and mental health professionals.
Book
Full-text available
As a result of recent media interest, the practice of BDSM has become more mainstream yet remains marginalized. Now more than ever, greater numbers of heterosexual and LGBTQ couples are starting to explore some form of BDSM. However, profound misunderstandings continue leading to unintentional physical and psychological harm. Drawing on current research and ethnographic narratives from the kink community, this book seeks to provide psychotherapists with an introductory understanding of the culture and practice of BDSM, and presents specific therapeutic concerns related to common misconceptions. This book strives to de-pathologize BDSM practices, while also providing concrete ways to distinguish abuse from consent, harmful codependency, and more. Packed with practical suggestions and rich case studies, this book belongs on the shelf of every therapist seeing BDSM and kink clients.
Article
It is important for health professionals to remember that despite narrow social scripts that define 'normal' sexuality, there remains tremendous sexual diversity across history and cultures.
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