I remember sitting at our gynecologist with my husband after we found out that I was pregnant with my second daughter. “Congratulations, so – do you have any more questions?”, he asked. We did. We really wanted to know about what BDSM techniques he deemed safe the first trimester. You know, a simple traffic light system: spanking: green, bondage: yellow, breathplay red. But it was hard to ask. My husband coughs. Dr. X raises an eyebrow.

  • Husband: “So, we were wondering…. Is it perfectly safe to have… rougher forms of sex?”
  • Dr. X chuckles: “Yes, it is. The embryo is well protected in there. Everything looks normal with you, so sex won’t hurt it.”
  • Me: “Yes…. like normal sex, but what about… rougher stuff?”
  • Dr. X: “Well you know, that depends a bit on HOW rough … <silence> ?”

We all giggle nervously and move on to talk about my low-carb diet. Interestingly enough an equally – if not more – controversial topic during pregnancy than kink. Yet, we had a perfectly normal, factual conversation. No giggles, no awkwardness. Low-carb, whilst controversial, is not a taboo.

Demystifying BDSM in Health Care

So why would BDSM be a taboo? After all, minutes before this doctor performed a transvaginal ultrasound on me. You know, that’s way past first base in my books. Also, his prime interest – like ours – was to protect our unborn child. So clearly it would be a good idea to discuss our kinky lifestyle with him. At least to the extent that we can rest assured that baby is safe.

That’s the power of stigma, and the danger of it. Beyond mental health consideration, also physicians – doctors, nurses of all disciplines – should be educated about BDSM. Kink-Aware Health Care creates professionals who are comfortable to talk about kink to their patients, as it touches their respective medical realms. They should have an idea about the basics of the dynamic and how to differentiate healthy, happy kink from abuse. Most importantly, they should create a judgment-free, no stigma safe-zone for their patients to talk freely.

Most Patients Don’t Dare to Come out to Physicians

Looking at a 2017 study by Waldura, Arora, Randall, Farala and Sprott with the catchy title “Fifty Shades of Stigma: Exploring the Health Care Experiences of Kink-Oriented Patients., my husband and I were not alone to keep our kinky skeletons in the closet. The study included 115 kinksters in the San Francisco area and the results are clear:

The study found that kink-oriented patients have genuine health care needs relating to their kink behaviors and social context. Most patients would prefer to be out to their health care providers so they can receive individualized care. However, fewer than half were out to their current provider, with anticipated stigma being the most common reason for avoiding disclosure. Patients are often concerned that clinicians will confuse their behaviors with intimate partner violence and they emphasized the consensual nature of their kink interactions.

And note, that this a group of people who are comfortable enough to identify themselves as kinksters to researchers. That’s already being pretty far out of the closet.

BDSM Practitioners Show Favorable Psychological Characteristics

The study “Psychological characteristics of BDSM practitioners. by Wismeijer and van Assen in 2013 established that kinksters are no worse off than vanilla folks:

“The results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group; BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable.”

This research includes 902 BDSM and 434 control participants who completely filled out online questionnaires. The researchers concluded that:

“BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes.”

A theory later picked up by the US National Library of Medicine in 2016 who investigated the question “Is BDSM a recreational leisure?” Results found that most BDSM experiences met leisure criteria. We’ve spoken to one of the researchers and shared more detail in our post ‘Kink Is a Hobby, not a Disorder”.

Too Little Education for Kink-Aware Health Care

The fact is that today, very few universities and colleges offer any sort of kink-related education to new doctors. There are barely any post graduate courses that would talk about the dynamics behind BDSM.

Given that void of education, I understand it’s somewhat daunting to talk kink for medical professionals. After all, like few other professions, there is a need to always be right and informed. Being ‘wrong’ in medicine has effects on a life-and-death basis. One of the reasons why I feel so at home in marketing – I deal with budgets not lives.

Health Care Professionals: Dare to Open up

So what I am saying is, I get it: I get that it’s scary as a physician, nurse, midwife to talk to BDSM-oriented patients if you don’t know what that kinky business is all about. When the line between alternative sexuality and abuse seems very thin and blurry.

At the same time, you cannot ignore parts of your patient’s life because it’s a bit scary. And we know from other research that thankfully, kinksters are very good at communicating about their needs. We might just need a little bit of help for doctors to open a door. In my case, a simple “What do you mean rough… like… BDSM stuff?” from Dr. X would have given my husband and me enough confidence to continue the conversation.

It’s okay to chuckle, it’s perfectly fine to say that this conversation feels a bit awkward. Kinksters are used to awkward. But do make sure you create that safe environment and that you don’t judge. Wether BDSM and Kink fit into your own moral compass or not, is irrelevant for the patient care you are providing.

Lecture: The Psychology of Kink

I am very proud that boldpleasures hosts a lecture on just this topic for doctors, nurses, therapists, midwives and other medical professionals on the basics around kink. If you are in Amsterdam, join us live on September 4th, 2018 at 19.00.

Sign Up for the Lecture

We’ll also offer the lecture online later this year, so make sure to sign up to our newsletter to hear when it’s launched. Join us on the road to kink-aware health care.

Until then, stay safe, stay sane & ditch shame!

Sonja is a co-founder of boldpleasures. She's on a mission to free people to revel in their true sensuality by removing the stigma surrounding kink. Sonja writes about first steps, ditching the shame and how to combine kink and 'normal' family life. She's a mother of two and happily married.

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