Content uploaded by Charles Moser
Author content
All content in this area was uploaded by Charles Moser on Nov 09, 2023
Content may be subject to copyright.
Received: February 26, 2023. Revised: August 7, 2023. Accepted: August 9, 2023
© International Society for Sexual Medicine 2023. All rights reserved. For Permissions, please email: journals.permissions@oup.com
The Journal of Sexual Medicine, 2023, 20, 1233–1234
https://doi.org/10.1093/jsxmed/qdad114
Expert Opinion
Differentiating sexual violence from BDSM
Charles Moser, PhD, MD
Diverse Sexualities Research and Education Institute, San Francisco, CA 94114, United States
Corresponding author: Diverse Sexualities Research and Education Institute, 4304-18th Street, #14752, San Francisco, CA 94114, United States.
Email: docx2@ix.netcom.com
Keywords: BDSM; Sexual Violence; Consent Violations; paraphilias.
BDSM (bondage and discipline, dominance and submission,
and sexual sadism and masochism) is a sexual interest and, for
some, a sexual orientation.1By definition, BDSM is consen-
sual. Sexual violence is characterized by intentional noncon-
sensual sexual behavior. Perpetrators of sexual violence often
disregard the desires and boundaries of their partners and use
force to overcome any resistance.
Although BDSM is consensual, BDSM participants may
engage in nonconsensual acts at times, just as a rapist may
engage in consensual intercourse at times. The difference
between coitus and rape is consent, and the difference between
BDSM and sexual violence is also consent. The differences
between BDSM and sexual violence are important and can
have significant legal consequences (criminal and civil) as well
as psychological ramifications for the individuals involved.
Due to similarities in the appearance and results of the
activities, it can be difficult to ascertain whether BDSM acts
were consensual. The present article is an attempt to famil-
iarize clinicians with some basic information to distinguish
sexual violence from BDSM. This article also may facilitate
the clinician’s cultural competence when interacting with the
BDSM community.
To complicate the distinction between sexual violence and
BDSM, there are BDSM participants who commit “consent
violations” (ie, engage in activities to which the participants
have not consented or ignore previously agreed-upon limits).2
Consent violations are not necessarily sexual violence. Often,
these are the result of misunderstandings, inexperience, or get-
ting caught up in the moment. Although many BDSM partic-
ipants have experienced these, such violations do not tend to
become a persistent pattern, but the emotional consequences
can be indistinguishable from sexual violence. Whether inten-
tional or not, an alleged consent violation is always serious.
A BDSM participant who commits a pattern of consent viola-
tions may be considered a sexually violent offender. There are
those who falsely profess consensual BDSM interests but prey
upon BDSM individuals.
Outside of legal proceedings, BDSM participants are rarely
diagnosed as having paraphilic disorders,3and perpetrators
of sexual violence are criminals and not necessarily diagnosed
with mental disorders. There are BDSM-oriented individuals
who do not self-identify as such, but their behaviors and
intents are indistinguishable from those who do. This is
analogous to people who engage in same-sex sexual activities
but do not define themselves as gay or bisexual.
Especially between individuals who have not previously
engaged in BDSM with each other, a discussion about consent
and limits (ie, agreement about which activities are prohibited)
is common, explicit, and detailed. Concerns about participants
changing their minds, misunderstandings, intoxication, regret
afterward, and being pressured during interactions to chang-
ing limits are no different than in other sexual interactions.
In general, BDSM interactions are safer for the participants
than interactions initiated outside the BDSM community.2It
should be noted that submissive and dominant partners have
limits that can be violated.
BDSM participants are usually aware of the fine line
between wonderful and way too much. BDSM organizations
are proactive in providing educational programs about
consent and delineating what constitutes a consent violation.
The information is available online (see https://www.conse
nt.academy/consent--sex.html,https://ncsfreedom.org/key-
programs-2/consent-counts/).
It is also important to distinguish between being triggered
(ie, intense reactions elicited by past negative events) and expe-
riencing nonconsensual acts. There can be further problems
when the interaction intensifies too quickly, reality does not
match the fantasy, or participants do not possess the skills to
engage in an activity safely. These are serious problems but do
not necessarily constitute sexual violence.
The pattern of physical marks (bruises, welts, scratches,
etc) can help distinguish BDSM from violence. BDSM rarely
involves facial bruising; rather, the marks often form a pattern,
suggesting that the recipient was not avoiding the blows,
whereas injuries from violence are more haphazard and defen-
sive wounds are common. Marks resulting from BDSM inter-
actions generally avoid the lower back, bony areas, and major
organs.4
Possibly the most useful question is “If you knew that your
partner was not enjoying the interaction, would that lessen or
increase your arousal?” BDSM participants usually are aware
when their partners are not enjoying an activity, and they
report that it would lessen their arousal. Perpetrators of sexual
violence are focused on their own enjoyment, would not care
or notice their partners’ reaction, or may be more aroused
by their partners’ lack of enjoyment. Even if an activity was
agreed on initially, consent can be withdrawn at any time.
Once it is withdrawn, persisting in the behavior can turn a
consensual encounter into sexual violence. The physiologic
signs of sexual arousal are not proxies for consent.
Downloaded from https://academic.oup.com/jsm/article/20/10/1233/7287413 by ISSM Member Access user on 08 October 2023
1234 The Journal of Sexual Medicine, 2023, Vol 20, Issue 10
Other important questions include “How did you know
your partner was enjoying it?” “Did your partner have or use
a safeword (ie, a word or gesture that means the activity needs
to stop)?” “Did you know what your partner’s limits were?”
“What did you negotiate would happen?”
Questions unlikely to help in determining if an individual
is sexually violent include “Were you or your partner turned
on?” “Did your partner ever use a safeword before?”“Do you
have a history of violating limits?” “Did your partner ever say
‘no’ or ‘stop’?” “Did your partner provoke you?”
In any sexual interaction, one partner may be too rough
or too gentle for the other partner. Some sexual activities
are arousing, some not so arousing, some tolerated, some
uncomfortable, and some can trigger the end of interaction.
If a partner is asked after an interaction, an honest appraisal
may include “I loved the oral sex, the coitus did not last long
enough, the nipple stimulation was great at first but became
irritating, the spanking was too tentative, but I would like to
see you again.”
The clinician should be aware that a number of BDSM
variations (eg, consensual nonconsent, domestic discipline)
may appear to be sexually violent but are actually prenego-
tiated consensual interactions. “Rape” fantasies are common,
but unlike an actual rape, the individual who is fantasizing
controls who, what, where, when, and so forth. This person is
free to stop or change the fantasy, which is not characteristic of
an actual rape. Rape play or reenactment usually occurs with
a trusted partner who can let the “victim” give up control.
Some people who have been raped report that rape play has
been therapeutic. Nevertheless, it can go very wrong.
BDSM interactions and relationships can and do end for a
variety of reasons. First-time BDSM interactions often occur
in semipublic settings where other BDSM practitioners can
intervene, or a participant can arrange a “safe call” (ie, if
the practitioner does not call by a certain time, the police
or authorities are alerted). These safeguards lower the risk of
becoming a victim.
Distinguishing between BDSM and sexual violence is pos-
sible and important, and it can avoid inappropriate referrals
or dismissals of these complaints.
Author contributions
C.M.: conceptualization, data curation, formal analysis, funding acqui-
sition, investigation, methodology, project administration, resources,
software, supervision, validation, visualization, writing–original draft,
writing–review and editing.
Funding
None declared.
Conflicts of interest
None declared.
References
1. Moser C. Defining sexual orientation. Arch Sex Behav. 2016;45(3):
505–508.
2. Wright S, Bowling J, McCabe S, Benson JK, Stambaugh R, Cramer
RJ. Sexual violence and nonconsensual experiences among alt-
sex communities’ members. J Interpers Violence. 2022;37(23-24):
NP21800–NP21825.
3. Moser C, Kleinplatz PJ. Conceptualization, history, and future of the
paraphilias. Annu Rev Clin Psychol. 2020;16(1):379–399.
4. Moser C. Demystifying alternative sexual behaviors. Sexuality,
Reproduction and Menopause. 2006;4(2):86–90.
Downloaded from https://academic.oup.com/jsm/article/20/10/1233/7287413 by ISSM Member Access user on 08 October 2023
