Rates of Injury and Healthcare Utilization for Kink-Identified Patients

J Sex Med. 2021 Oct;18(10):1721-1734. doi: 10.1016/j.jsxm.2021.08.001. Epub 2021 Sep 2.


Background: Kink-involved people engage in atypical erotic activities such as bondage, rough sex, and other fetish activities that might risk injury or medical complication. To date, however, no one has examined the rate of injury or healthcare utilization for people who engage in these activities.

Aim: To describe the type and rate of injuries from kink activities, and the use of healthcare by kink-involved people, including how many people disclose their involvement in kink when seeking care.

Methods: A survey of 1,398 kink-involved or kink-identified people, using a convenience sampling method.

Outcomes: The study is the first to report on rates of injury and disclosure of kink involvement to care providers using a large community sample of kink-involved people.

Results: A high number of participants did not disclose their kink behavior to their physical healthcare clinician (58.3%) or to their mental healthcare clinician (49.6%). Past experiences of kink-related injuries were relatively common (13.5%), as was the number of people who reported delaying or avoiding healthcare because of anticipated or perceived stigma for kink involvement (19.0%).

Clinical translation: The findings of the current study point to the need for clinicians to address barriers to culturally competent care for kink-involved people. Anticipated stigma leads to non-disclosure of kink involvement and delay in seeking care, thereby creating barriers to health and well-being.

Strengths & limitations: Strengths include a sample size large enough to examine regression models to predict disclosure to care providers, and lifetime rates of injury from kink activities overall. Limitations include the use of a convenience sampling method and self-report survey design, which affect the generalizability of the results.

Conclusion: The patterns of anticipated stigma, delay or avoidance of care, and concealment of kink and/or BDSM involvement fit the Minority Stress Model, and we argue that kink-identified people should be considered a sexual minority for the purposes of healthcare. Sprott RA, Randall A, Smith K et al. Rates of Injury and Healthcare Utilization for Kink-Identified Patients. J Sex Med 2021;18:1721-1734.

Keywords: BDSM; Cultural Competence; Fetish; Healthcare Utilization; Injury; Kink; Primary Care; Sexual Minority; Stigma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disclosure
  • Humans
  • Minority Groups
  • Patient Acceptance of Health Care*
  • Social Stigma*
  • Surveys and Questionnaires