Hansen-Brown et al's “Perceptions of and stigma toward BDSM practitioners” (2022)
“Perceptions of and stigma toward BDSM practitioners”
[W]e found that the general population (N = 257) does stigmatize BDSM practitioners more than the gay/lesbian population, and both are stigmatized more than a low-stigma comparison group (people in romantic relationships)
Though BDSM (bondage/discipline, dominance/submission, sadism/masochism) practitioners have received increasing academic attention over the past decades (for a review, see Simula, 2019), this population still remains under-studied, particularly in regard to how individuals in the general population perceive and stigmatize them.
A not insignificant minority of the population practices BDSM, though to varying degrees; for example, as many as 46.8% of Belgians have performed at least one BDSM activity (Holvoet et al., 2017). A recent nationally representative survey of U.S. participants found that the prevalence of role playing (>22%) and tying/being tied up (>20%) is higher than lifetime practice of attending BDSM parties or classes (<8%; Herbenick et al., 2017). Research suggests that a large percentage of the general population have entertained BDSM-related fantasies, with some estimates as high as 68% (Holvoet et al., 2017; Powls & Davies, 2012). However, factors such as difficulty defining BDSM, providing inconsistent information about BDSM to survey participants, and anticipated stigmatization make exact prevalence rates difficult to determine (Brown et al., 2019).
Many parallels can be drawn between other individuals who do not meet conventional heterosexual norms and BDSM practitioners. BDSM practitioners suffer from a pathology narrative, where people in the general population often believe BDSM is an unhealthy sexuality indicative of past trauma (Hughes & Hammack, 2019; Nichols, 2006). This narrative is in many ways similar to the historical pathology narrative of homosexuality; however, although the narrative for homosexuality has been increasingly discredited both in healthcare professions and mainstream culture, progress in discrediting the narrative for BDSM community members is still in its infancy (Hammack et al., 2013; Herek, 2010; Hughes & Hammack, 2019; Nichols, 2006; Whitehead et al., 2016). The most recent DSM-5 now states that involvement in BDSM activities does not automatically qualify for “paraphilic disorder” unless accompanied by significant psychological distress or engaging in these activities with non-consenting persons, the latter of which is a form of abuse (American Psychiatric Association, 2013). This is a step toward de-medicalization and de-stigmatization of this community (Lin, 2016). Yet much work remains to be done; for example, mental health professionals tend to feel more uncomfortable working with BDSM community members compared to working with gay/lesbian clients and/or clients who engage in group sex behaviors (Ford & Hendrick, 2003), and the risk of uninformed medical and mental health care professionals stigmatizing BDSM clients remains high (Kolmes et al, 2006; Sprott & Randall, 2017).
[A] recent study completed in Belgium found high rates of stigmatization against BDSM practitioners (Schuerwegen et al., 2020). The authors found that 86% of their self-report sample agreed with at least one stigmatizing attitude toward BDSM practitioners (example scale items: “I wouldn’t want someone who practices BDSM looking over my children” and “Severe SM practices should be prosecutable”); only 14% of the sample did not agree with any of the stigmatizing statements. Additionally, 77% of participants reported that they endorsed at least one discriminatory attitude (example scale item: “I wouldn’t mind living next to someone who practices BDSM”, reverse-scored).
[O]ne-third [of the BDSM community] choose not to disclose their participation in BDSM to their mental healthcare providers (Kolmes et al., 2006). Their fears are not baseless; in some states, medical professionals are required to report any suspicious bruising a patient has even if they are informed that the bruises were from consensual activities (Houry et al., 2002). The lack of knowledge about BDSM community members extends to mental healthcare professionals as well; a recent study found that 14% of therapists surveyed thought that sexual masochism could not be practiced in healthy ways and 29% believed that sexual sadism is unhealthy (Kelsey et al., 2013).
[R]esearch suggests that although the academic community has become more accepting over time of BDSM as a subculture, the general public has not (Stiles & Clark, 2011; Weiss, 2006). For example, although college students tend to believe that BDSM is not socially wrong and should be tolerated, they also tend to believe that BDSM community members are prone to either commit or be victims of non-consensual violence (Yost, 2010).
[T]hese results supported our hypothesis that BDSM practitioners face a higher rate of stigma than either gay/lesbian people or people in romantic relationships. Our supplemental analyses suggested that this stigma exists irrespective of COVID stress, and that stigma levels do not change based on participants’ age or gender. These stigma differences seem to reflect the pathology narrative toward both the BDSM and gay/lesbian populations, given that our general population sample stigmatized both groups more than people in romantic relationships generally. Importantly, our finding that the general population stigmatized BDSM practitioners significantly more than the gay/lesbian community also reflects the much greater progress toward de-medicalization and de-stigmatization for the gay/lesbian community compared to the BDSM community (Lin, 2016).
Much previous research about stigmatization of BDSM practitioners in the healthcare system and prejudice toward BDSM practitioners from college students and other populations is years or decades old, yet the current research suggests stigmatization still exists today.
Another area for future research is to examine exactly why this stigma still exists today. We have speculated earlier in this paper, along with other researchers, that it may be at least partially due to misrepresentation of the BDSM culture in popular media, as with the inaccuracies in Fifty Shades of Grey around the role of consent. Though we did not test this as an explanatory mechanism in our study, future research could do so to test whether this is the case.
Limitations to the generalizability of our findings primarily center around sample composition and size. Our sample in this study was recruited from Amazon’s Mechanical Turk, which is of course not a true random sample. Previous research has suggested that samples gathered from MTurk are more demographically more diverse than the college student samples often used in psychological research, but still tend to be somewhat younger, better educated, and more White than the U.S. population as a whole (see Sheehan, 2018). Sample composition may have affected our findings; for example, perhaps we would have found even stronger stigmatization effects if our sample skewed older or less educated. Further, many researchers have recently called into question the reliability of findings obtained from Amazon’s Mechanical Turk, as well as their generalizability (e.g., Chmielewski & Kucker, 2020).
[T]he current research did not measure gay/lesbian people’s perceptions of the BDSM community, nor did it measure BDSM community members’ perceptions of gay/lesbian people.
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