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Autoerotic asphyxia – a potentially fatal deviance


November 29, 2021
By Peter Collins

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During one’s policing career, responding to a death scene where an individual is found hanging is not all that uncommon. Most of these deaths are from suicide, however a small percentage are due to autoerotic asphyxiation. Autoerotic asphyxia is the practice of inducing cerebral anoxia, usually by means of self-applied ligatures or suffocating devices, while the individual tries to masturbate to orgasm. This activity, which is found almost exclusively in men, sometimes results in death when the individual’s self-rescue mechanism fails, or he loses consciousness before he can employ it.

Many victims of autoerotic death are Caucasian males between the second and fourth decade, however experts estimate that five to seven per cent of autoerotic deaths occur in females. While autoerotic death may encompass a number of other means of achieving sexual gratification, the most common method is by ligature around the neck.

As previously noted in my Blue Line Behavioural Science columns, the majority of individuals who are paraphilic (sexually deviant) do not ‘specialize’ in just one deviant activity. The majority are engaged in two or three or more cross-associated sexual deviances. The same holds true for autoerotic asphyxia – a proportion of these men are also erotically aroused by transvestism and/or bondage.

Research by Canadian forensic psychiatrist, Dr. Stephen Hucker, found that the mean age was 26 with a range of 10 to 56 years. In nearly all the published series, self-hanging was the common method employed, with 82 per cent using this method, either alone or in combination with some other asphyxiating mechanism.

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Investigators may find multiple grooves on a beam used to support the rope, or other evidence that the procedure has been repeated several times.

In addition to evidence of repetition, to distinguish an autoerotic fatality from a suicide, the investigator must determine how the deceased would have tried to avoid such a mishap. Sometimes a slip-knot mechanism is used to ensure a quick release of pressure on the neck and allow return of consciousness. In a few autoerotic fatalities, the deceased may have used an elaborate asphyxiating device or apparatus that requires careful investigation to demonstrate how the person could have applied it and then disentangled themselves.

The majority of individuals who are paraphilic (sexually deviant) do not ‘specialize’ in just one deviant activity.

The fact that the subject is nude, partially nude or cross-dressed may also be evidence of a paraphilic act as opposed to suicide.

Bondage is evident in many cases. Present are physical restraints on the body that are independent of the method of asphyxiation. Thus, the neck, head, ankles, thighs, chest or abdomen may have been bound, the genitals ligated, the hands bound or handcuffed and sometimes there would be a hood or blindfold. Genitals may also be bound. Occasionally a dildo, vibrator or foreign object is inserted in the anus.

Sexually deviant activity is fantasy-motivated and evidence may be found adjacent to the decadent – mirrors, cameras for self-photography, self-written fantasy material, fetish items and pornography that is being viewed either on a computer or magazines.

Investigator’s checklist

Geberth provides a list of questions that the investigator should consider in determining whether the death is related to sexual asphyxia:

  1. Is the victim nude, sexually exposed or wearing articles of feminine attire, such as makeup and wigs?
  2. Is there evidence of masturbatory activity – tissues, seminal fluids?
  3. Is there evidence of piercings or causing pain to the genitalia, pins in the penis, etc.?
  4. Are sexually stimulating paraphernalia present: vibrators, pornographic magazines, butt plugs, etc.?
  5. Is bondage present: ropes, chains, blindfolds, gags, etc.? Are there any constricted devices present: plastic wrap, belts, ropes, vacuum cleaner hoses around the body, or chest constraints?
  6. Is there protective padding between the ligature in the neck to prevent rope burns or discomfort?
  7. Are the restraints interconnected? Do the ropes come together or are they connected? Are the chains interconnected? Is the victim tied to himself, so by putting pressure on one of the limbs the restraints are tight?
  8. Are mirrors or other reflected devices present and positioned so the victim can view his or her activities?
  9. Is there evidence of fantasy (diaries, erotic literature, etc.) or fetishism?
  10. Is the suspension point within reach of the victim or is there a skate mechanism (keys, lock, slipknot, etc.)?
  11. Is there evidence of prior activities of a similar nature (abrasions or rope burns on the suspension point); unexplained secretive behaviour, or long stays in isolated areas; rope burns on neck, etc.?
  12. Does the victim possess literature dealing with bondage, escapology, or knots?
  13. Is there a positioned camera or video camera?

Copy cats

I was somewhat hesitant in writing this article because there is a copycat element to these acts, predominantly by adolescents. In May 1998, the Oprah Winfrey Show addressed the issue of autoerotic fixation in one of their shows. One of the guests was a woman whose son died after engaging in this behaviour. She unsuccessfully sued Hustler magazine, which had published an article entitled “Orgasm of Death”. Despite the dangers being outlined in the Hustler article, her 14-year-old son died with the magazine article lying at his feet. A learned colleague, Dr. Park Dietz, warned the producers of the show that other deaths could follow; he may have been correct. At least two deaths could be linked as a result of the television program involving an 11-year-old boy and a 38-year-old man.

References

Hucker, S. (2011). Hypoxyphilia Archives of Sex Behaviour (2011) 40:1323–1326.

Hucker, S. & Blanchard, R. (1992). Death scene characteristics in 118 fatal cases of autoerotic asphyxia compared with suicidal asphyxia. Behavioral Sciences and the Law, 10, 509–523.

Geberth, G. (2010) Sex-Related Homicide and Death Investigation: practical and clinical perspectives 2nd Edition. CRC Press: Boca Raton.

Sauvagneau, A. & Racette, S. (2006) Autoerotic Deaths in the Literature from 1954 to 2004: a review. Journal of Forensic Sciences, 51 (1), 140-146.


Dr. Peter Collins is the operational forensic psychiatrist with the Ontario Provincial Police’s Criminal Behaviour Analysis Section. He is also a member of the crisis/hostage negotiation team of the Toronto Police Service Emergency Task Force. Dr. Collins’ opinions are his own. Contact him at peter.collins@utoronto.ca.


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