Challenging the Stigma Around Breath Play

Challenging the Stigma Around Breath Play

The BDSM (bondage-discipline, dominance-submission, and/or sadism-masochism) community has often faced stigma for their sexual preferences. In fact, past and present medical literature has described BDSM (or kink) as “bizarre,” “unusual,” and even indicative of a mental disorder or dysfunction.

However, many sexuality experts hope to reframe the conversation around consensual BDSM activities between adult participants. They argue that language that portrays BDSM as abnormal or psychologically unhealthy is flawed because past studies have shown that BDSM practitioners exhibit similar or even better mental health than control populations. What’s more, these preconceived ideas about kink and its practitioners may increase discrimination around the practice and create barriers to resources and health care for individuals who wish to practice BDSM safely.

One such stigmatized BDSM activity is erotic asphyxiation, which was the topic of discussion in a recent expert opinion paper submitted to The Journal of Sexual Medicine. Erotic asphyxiation is the practice of temporarily restricting one’s oxygen supply while engaging in sexual stimulation as a way of enhancing the experience. Autoerotic asphyxiation is used to describe a situation in which an individual performs the act alone. Although these terms are often still used to describe this practice, “breath play” is becoming a more frequent and universally accepted term for it.

According to the author of this paper, most information on autoerotic asphyxiation focuses on accidental deaths caused by the practice. Certainly, like any other type of accidental death, these cases are tragic and should not be ignored. Nonetheless, the author points out that other activities in life are similarly unsafe, yet do not carry the stigma of erotic asphyxiation/breath play.

An example is deep-sea freediving, during which individuals dive under water without any breathing equipment. While this activity has the same risks and consequences as erotic asphyxiation, it does not bear the same stigma, and its practitioners are not considered to be psychologically unwell. In this vein, the argument could be made that while breath play, like freediving, can be dangerous, those who practice it do not (necessarily) have mental health issues.

This is important because if people who practice erotic asphyxiation are made to feel ashamed of it, they may practice breath play in an unsafe way. Online forums and other resources can support people with ideas on how to engage in breath play in a safer manner, but data shows that about 50% of people who do breath play have not sought out information on it. Furthermore, these individuals may be less likely to take precautions that involve telling others about the practice due to shame (i.e., not informing another person when performing autoerotic asphyxiation in case things go wrong).

Ultimately, the author urges health care providers and others to work towards reducing the stigma around breath play. In doing so, there may be greater potential for open conversation around erotic asphyxiation and better access to resources for practitioners to make the activity as safe as possible.


  • Cardoso, D. (2022). Choking autoerotic asphyxiation: for a reconfiguration of discourses around breath play. The Journal of Sexual Medicine, 19(7), 1069-1072. DOI:

  • Wismeijer, A. A., & Van Assen, M. A. (2013). Psychological characteristics of BDSM practitioners. The journal of sexual medicine10(8), 1943-1952. DOI:

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