Erotic asphyxiation

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Erotic asphyxiation (variously called asphyxiophilia, hypoxyphilia or breath control play) is the intentional restriction of oxygen to the brain for the purposes of sexual arousal. The term autoerotic asphyxiation is used when the act is done by a person to themselves. Colloquially, a person engaging in the activity is sometimes called a gasper.[1]

The erotic interest in asphyxiation is classified as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association.

Erotic asphyxiation can lead to accidental death due to asphyxia.


Concerning hallucinogenic states brought about by chronic hypoxia, Dr. E. L. Lloyd notes that they may be similar to the hallucinations experienced by climbers at altitude. He further notes that no such state occurs in hypoxia brought about by sudden aircraft decompression at altitude. These findings suggest to him that they do not arrive purely from a lack of oxygen. Upon examining the studies on hypoxia he found that "abnormalities in the cerebral neurochemistry involving one or more of the interconnected neurotransmitters, dopamine, serotonin, and beta-endorphin had been reported in all the conditions associated with hallucinations."[2]


Historically, the practice of autoerotic asphyxiation has been documented since the early 17th century. It was first used as a treatment for erectile dysfunction. The idea for this most likely came from subjects who were executed by hanging. Observers at public hangings noted that male victims developed an erection, sometimes remaining after death (a death erection), and occasionally ejaculated when being hanged.[3]


Various methods are used to achieve the level of oxygen depletion needed, such as a hanging, suffocation with a plastic bag over the head, self-strangulation such as with a ligature, gas or volatile solvents, chest compression, or some combination of these.[4] Sometimes, complicated devices are used to produce the desired effects.[5] The practice can be dangerous even if performed with care and has resulted in a significant number of accidental deaths. Uva (1995) writes “Estimates of the mortality rate of autoerotic asphyxia range from 250 to 1000 deaths per year in the United States.”[6] Cases have also been reported in Scandinavia[7] and Germany.[8][9] Autoerotic asphyxiation may often be mistaken for suicide, which is a major cause of death in teenagers.[10]

Accidental death

Deaths often occur when the loss of consciousness caused by partial asphyxia leads to loss of control over the means of strangulation, resulting in continued asphyxia and death. While often asphyxiophilia is incorporated into sex with a partner, others enjoy this behaviour by themselves, making it potentially more difficult to get out of dangerous situations.[11]

In some fatality cases, the body of the asphyxiophilic individual is discovered naked or with genitalia in hand, with pornographic material or sex toys present, or with evidence of having orgasmed prior to death.[8] Bodies found at the scene of an accidental death often show evidence of other paraphilic activities,[12] such as fetishistic cross-dressing and masochism.[4] In cases involving teenagers at home, families may disturb the scene by "sanitizing" it, removing evidence of paraphilic activity. This can have the consequence of making the death appear to be a deliberate suicide, rather than an accident.[13]

The great majority of known erotic asphyxial deaths are male; among all known cases in Ontario and Alberta from 1974 to 1987, only 1 out of 117 cases was female.[4] Some individual cases of women with erotic asphyxia have been reported.[14][15][16][17] The main age of accidental death is mid-20s,[4][18] but deaths have been reported in adolescents[19][20][21] and in men in their 70s.[8][18]

Autoerotic asphyxiation has at times been incorrectly diagnosed as murder and especially so when a partner is present.[citation needed]

Lawyers and insurance companies have brought cases to the attention of clinicians because some life insurance claims are payable in the event of accidental death, but not suicide.[22][23][24]

Famous cases

Newspaper photo taken shortly after the arrest of Sada Abe (center) in Tokyo on May 20, 1936

Although Paula Yates contradicted earlier statements she had made by saying during a 1999 interview that Michael Hutchence’s 1997 death might have been caused by autoerotic asphyxiation,[25] the coronial inquest found it to be suicide due to a combination of depression and intoxication with alcohol and other drugs.[26]

  • Peter Anthony Motteux, English author, playwright, translator, publisher and editor of The Gentleman's Journal, "the first English magazine", from 1692 to 1694, died from apparent autoerotic asphyxiation in 1718, which is probably the first recorded case.
  • Frantisek Kotzwara, composer, died from erotic asphyxiation in 1791.
  • Sada Abe killed her lover, Kichizo Ishida through strangulation while he was sleeping, after having experimented with erotic asphyxiation, in 1936, proceeding to cut off his penis and testicles and carry them around with her in her handbag for three days. The case caused a sensation in 1930s Japan and has remained one of the most famous Japanese murder cases of all time.
  • Albert Dekker, stage and screen actor, was found dead in his bathroom in 1968 with his body graffitied and a noose around his neck.
  • Nigel Tetley (c. 1924 – 2 February 1972) was a British sailor who was the first person to circumnavigate the world solo in a trimaran. His body was found hanging from a tree in woods near Dover, England. At the coroner's inquest, it was revealed that the body had been discovered clothed in lingerie and the hands were bound behind the back. The opinion offered by a pathologist suggested masochistic sexual activity.
  • Vaughn Bodé, artist, died from this cause in 1975.
  • Diane Herceg sued Hustler magazine in 1983, accusing it of causing the death of her 14-year-old son, Troy D., who had experimented with autoerotic asphyxia after reading about it in that publication.[27]
  • Stephen Milligan, a British politician and Conservative MP for Eastleigh, died from autoerotic asphyxiation combined with self-bondage in 1994.[28]
  • Kevin Gilbert, a musician and songwriter, died of apparent autoerotic asphyxiation in 1996.[29]
  • David Carradine died on June 4, 2009 from accidental asphyxiation, according to the medical examiner who performed a private autopsy on the actor.[30][31] His body was found hanging by a rope in a closet in his hotel room in Thailand,[32][33] and there was evidence of a recent orgasm;[34] two autopsies were conducted and concluded that his death was not suicide, and the Thai forensic pathologist who examined the body stated that his death may have been due to autoerotic asphyxiation.[35][36] Two of Carradine's ex-wives, Gail Jensen[37][38] and Marina Anderson,[39][40] stated publicly that his sexual interests included the practice of self-bondage.

In fiction

The sensational nature of erotic asphyxiation often makes it the subject of urban legends. It has also been mentioned specifically in a number of works of fiction.

  • In the Marquis de Sade's famous novel Justine, or The Misfortunes of the Virtue, Justine is subjected to this by one of her captors. She survives the encounter.
  • In the Guts short story in Chuck Palahniuk's novel Haunted, one the characters discusses parents who discover the accidental deaths of their sons to autoerotic asphyxiation. They are said to cover up the deaths before police or coroners arrive to save the family from shame.
  • In the novel (and later movie adaptation) Rising Sun, death as a result of this type of sexual arousal is explained when it is offered as a possible cause for a murder victim's death.
  • In the film World's Greatest Dad, the protagonist's teenage son accidentally kills himself with asphyxiation whilst sexually aroused. The protagonist then stages his son's death as a suicide, which gives him the opportunity to rise to infamy through a literary hoax.
  • In the film Ken Park a character named Tate practices autoerotic asphyxia.
  • Autoerotic asphyxiation occurs in the cold open of Six Feet Under episode Back to the Garden.
  • Kenny from South Park dies from suffocating while wearing a Batman costume and practicing autoerotic asphyxia in the episode "Sexual Healing".
  • In the season four episode of Californication, titled "Monkey Business", the character Zig Semetauer is found dead in his bathroom by Hank, Charlie and Stu after suffocating due to autoerotic asphyxia, to which Hank quips "I'm not averse to the occasional choke-n'-stroke, but this is a prime example of why one must always use a buddy system."
  • A character in the film Knocked Up offers to be a "spotter" for a friend if he intends on performing autoerotic asphyxiation.
  • Bruce Robertson, the main character in the 1998 Irvine Welsh novel, Filth, engages in the practice. This is also depicted in the 2013 film adaptation.
  • In the sixth episode, season two of BoJack Horseman, autoerotic asphyxiation and celebrity deaths are recurrent discussions.
  • In the episode, "Clyde Bruckman's Final Repose" of the TV series The X-Files, a psychic implies that special agent Fox Mulder will die by autoerotic asphyxiation.

See also


  1. Roberts, Chris (30 January 2012). Lost English: Words And Phrases That Have Vanished From Our Language. Michael O'Mara Books. p. 66. ISBN 978-1843172789.
  2. Dr. E L Lloyd (29 March 1986). "Points: Hallucinations, hypoxia, and neurotransmitters". British Medical Journal Volume 292: 903. {{cite journal}}: Cite journal requires |journal= (help)
  3. "Erotic Asphyxiation". Lust Magazine. 1997. Archived from the original on 2006-08-31. Retrieved 2006-09-02.
  4. 4.0 4.1 4.2 4.3 Blanchard, R.; Hucker, S. J. (1991). "Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia". British Journal of Psychiatry. 159 (3): 371–377. doi:10.1192/bjp.159.3.371. PMID 1958948.
  5. O'Halloran, R. L.; Dietz, P. E. (1993). "Autoerotic fatalities with power hydraulics". Journal of Forensic Sciences. 38 (2): 359–364. doi:10.1520/JFS13416J.
  6. Uva, J. L. (1995). "Review: Autoerotic asphyxiation in the United States". Journal of Forensic Sciences. 40 (4): 574–581. doi:10.1520/JFS13828J. PMID 7595293.
  7. Innala, S. M.; Ernulf, K. F. (1989). "Asphyxiophilia in Scandinavia". Archives of Sexual Behavior. 18 (3): 181–189. doi:10.1007/BF01543193. PMID 2787626.
  8. 8.0 8.1 8.2 Janssen, W.; Koops, E.; Anders, S.; Kuhn, S.; Püschel, K. (2005). "Forensic aspects of 40 accidental autoerotic death in Northern Germany". Forensic Science International. 147S: S61–S64. doi:10.1016/j.forsciint.2004.09.093. PMID 15694733.
  9. Koops, E.; Janssen, W.; Anders, S.; Püschel, K. (2005). "Unusual phenomenology of autoerotic fatalities". Forensic Science International. 147S: S65–S67. doi:10.1016/j.forsciint.2004.09.095. PMID 15694734.
  10. Downs, Martin (January 1, 2005). "The Highest Price For Pleasure: A Deadly Turn-On". WebMD. Archived from the original on December 28, 2011. Retrieved October 4, 2011.
  11. Autoerotic Asphyxiophilia Archived 2009-05-15 at the Wayback Machine on 'Sexinfo' website, University of Santa Barbara, Ca.
  12. Bogliolo, L. R.; Taff, M. L.; Stephens, P. J.; Money, J. (1991). "A case of autoerotic asphyxia associated with multiplex paraphilia". American Journal of Forensic Medicine and Pathology. 12 (1): 64–73. doi:10.1097/00000433-199103000-00012. PMID 2063821.
  13. Downs, Martin. The Highest Price for Pleasure Archived 2011-12-28 at the Wayback Machine, featured by WebMD
  14. Danto, B. (1980). "A case of female autoerotic death". American Journal of Forensic Medicine and Pathology. 1 (2): 117–121. doi:10.1097/00000433-198006000-00004. PMID 7246503.
  15. Behrendt, N.; Buhl, N.; Seidl, S. (2002). "The lethal paraphilic syndrome: Accidental autoerotic deaths in four women and a review of the literature". International Journal of Legal Medicine. 116 (3): 148–152. doi:10.1007/s00414-001-0271-x. PMID 12111317.
  16. Martz, D. (2003). "Behavioral treatment for a female engaging in autoerotic asphyxiation" (PDF). Clinical Case Studies. 2 (3): 236–242. doi:10.1177/1534650103002003006. Archived (PDF) from the original on 2021-02-24. Retrieved 2019-07-12.
  17. Sass, F. (1975). "Sexual asphyxia in the female". Journal of Forensic Sciences. 2: 181–185.
  18. 18.0 18.1 Burgess, A. W.; Hazelwood, R. R. (1983). "Autoerotic deaths and social network response". American Journal of Orthopsychiatry. 53 (1): 166–170. doi:10.1111/j.1939-0025.1983.tb03361.x. PMID 6829721.
  19. Shankel, L. W.; Carr, A. C. (1956). "Transvestism and hanging episodes in a male adolescent". Psychiatric Quarterly. 30 (3): 478–493. doi:10.1007/BF01564363. PMID 13359556.
  20. Sheehan, W.; Garfinkel, B. D. (1987). "Adolescent autoerotic deaths". Journal of the American Academy of Child and Adolescent Psychiatry. 27 (3): 367–370. doi:10.1097/00004583-198805000-00017. PMID 3379021.
  21. Edmondson, J. S. (1972). "A case of sexual asphyxis without fatal termination". British Journal of Psychiatry. 121 (563): 437–438. doi:10.1192/bjp.121.4.437. PMID 5077101.
  22. Cooper, A. J. (1995). ""Auto-erotic asphyxial death: Analysis of nineteen fatalities in Alberta": Comment". Canadian Journal of Psychiatry. 40 (6): 363–364. doi:10.1177/070674379504000626. PMID 7585413.
  23. Cooper, A. J. (1996). "Auto-erotic asphyxiation: Three case reports". Journal of Sex and Marital Therapy. 22 (1): 47–53. doi:10.1080/00926239608405305. PMID 8699497.
  24. Garza-Leal, J. A.; Landrom, F. J. (1991). "Autoerotic death initially misinterpreted as suicide and a review of the literature". Journal of Forensic Sciences. 36 (6): 1753–1759. doi:10.1520/JFS13200J. PMID 1770343.
  25. Archived 2017-09-05 at the Wayback Machine "Paula challenges Hutchence verdict". BBC News (BBC). 10 August 1999. Retrieved 9 December 2010.
  26. Hand, Derrick; Fife-Yeomans, Janet (2008) [2004]. The Coroner: Investigating Sudden Death. Sydney, NSW: Allen & Unwin. ISBN 978-0-7333-2221-1.
  27. John W. Williams (1990). "Can the media kill? A syndrome, a case study and the law". Archived from the original on 2009-06-09. Retrieved 2009-03-23.
  28. "Police probe MP's suspicious death Archived 2008-03-07 at the Wayback Machine". BBC News, 8 February 1994
  29. Joel Selvin (September 16, 1996). "More Than 'The Piano Player'". San Francisco Chronicle. Archived from the original on 2008-09-19. Retrieved 2009-01-04.
  30. Orloff, Brian. "David Carradine Died of Accidental Asphyxiation" Archived 2009-08-31 at the Wayback Machine. People, July 2, 2009.
  31. "David Carradine's Official Cause of Death was Asphyxiation". 2009-07-02. Archived from the original on 2014-03-04. Retrieved 2014-02-28.
  32. Goldman, Russell (2009-06-04). "Police: Carradine Found Naked, Hanged in Closet". ABC News. Archived from the original on 2009-06-07. Retrieved 2009-06-04.
  33. "Actor David Carradine Found Dead". CNN. 2009-06-04. Archived from the original on 2009-06-08. Retrieved 2009-06-04.
  34. "Forensic Scientist Says Carradine Death May Be Linked to Auto-Erotic Asphyxiation". Fox News. 2009-06-05. Archived from the original on 2010-11-15. Retrieved 2010-03-25.
  35. "Carradine Death 'Erotic Asphyxiation'". Bangkok Post. 2009-06-06. Retrieved 2009-06-05.
  36. Drummond, Andrew (2009-06-05). "Kung Fu Star David Carradine Died 'When Auto Erotic Sex Game Went Wrong'". Daily Record. Archived from the original on 2009-06-12. Retrieved 2009-06-05.
  37. James, Susan Donaldson (June 9, 2009). "Ex-Wife Reveals David Carradine's 'Kinky' Habits". ABC News. Archived from the original on 2009-06-10. Retrieved 2009-06-09.
  38. "David Carradine Branded 'Strange' by Ex". June 9, 2009. Archived from the original on 2009-06-12. Retrieved 2009-06-11.
  39. McShane, Larry (June 5, 2009). "David Carradine a Fan of 'Potentially Deadly' Deviant Sex Acts, Ex-Wife Said in Court Papers". New York Daily News. Archived from the original on 2009-06-08. Retrieved 2009-06-10.
  40. Darwar, Anil (June 8, 2009). "Carradine Loved Deadly Sex Games, Says Ex-Wife". Daily Express. Archived from the original on 2009-06-13. Retrieved 2009-06-10.

Further reading

  • Robert R. Hazelwood, Park Elliot Dietz, Ann Wolbert Burgess: Autoerotic Fatalities. Lexington, Mass.: LexingtonBooks, 1983.
  • Sergey Sheleg, Edwin Ehrlich: Autoerotic Asphyxiation: Forensic, Medical, and Social Aspects, Wheatmark (August 15, 2006), trade paperback, 208 pages ISBN 1587366045 ISBN 978-1587366048
  • John Money, Gordon Wainwright and David Hingsburger: The Breathless Orgasm: A Lovemap Biography of Asphyxiophilia. Buffalo, New York: Prometheus Books, 1991.

External links