Akademik Veri Yönetim Sistemi
TPD Yıllık Toplantısı ve 1. Uluslararası 25. Ulusal Klinik Eğitim Sempozyumu, İzmir, Türkiye, 19 - 22 Mayıs 2022, ss.73, (Özet Bildiri)
BACKGROUND AND AIM: BDSM is an acronym for “bondagediscipline, dominance-submission, sadism, masochism”. It is hard to
determine an exact definition of BDSM, but it often includes sexual
behaviour involving some type of exchange of power between partners
and/or the use of pain for sexual pleasure. Many sexual health researchers
object to the inclusion of BDSM practices in medical diagnostic
guidelines because they stigmatize BDSM practitioners and medicalize
relatively common sexual interests.
BDSM practitioners may seek psychiatric support for both BDSMrelated and different mental problems, but most healthcare professionals
are not familiar with these practices. It is known that stigma has a
negative effect on the quality of life (QOL). Although the frequency of
those who state that they have practiced BDSM at least once in their
life is around 50%, it is seen that there are prejudices and a lack of
knowledge among health authorities regarding this issue. One of the
critical consequences of this situation is the possibility of significantly
affecting people's QOL due to their sexual practices. This study aims to
evaluate whether there is a difference in the QOL between those who
define themselves as BDSM practitioners and the general population.
We also aim to examine the effects of being discriminated against due to
sexual practices on the QOL in BDSM practitioners.
METHODS: 141 people (65 women, 76 men) aged 18 and over who
defined themselves as BDSM practitioners were included in the study
with the snowball technique through websites that are accessible on the
internet and BDSM groups in social networks. The study was carried
out with the Google forms application, which was sent individually to
those who agreed to participate in the research via the internet. To reach
the control group, another form was prepared (which only excludes
questions about BDSM practices) and was placed on two popular
national websites. 167 volunteer participants (88 women, 79 men) who
stated that they were not BDSM practitioners and filled out the form
completely were taken as the control group.
The data form of our study includes the sociodemographic information
of the participants, their level of knowledge about sexual health, the
discrimination they experience while seeking medical/psychological
help, and the World Health Organization Quality of Life Scale - Short
Form (WHOQOL - BREF). WHOQOL – BREF measures general,
physical, mental, social, and environmental well-being and consists of
26 questions. Each area, independently of each other, shows the quality
of life as a percentage value.
Ethics committee approval was obtained for the study by Acıbadem
Mehmet Ali Aydınlar University Medical Research Evaluation
Committee on 21.04.2021 with the number 2021/08. Data were
collected between 01.05.2021 and 31.07.2021.
RESULTS: The mean age of the BDSM group (n = 141) was 31.04
(standard deviation [SD], 5.171). 46.1% (n = 65) of the BDSM
practitioners participating in our study were female and 53.9% (n =
76) were male. Considering their sexual orientation, 60.3% (n = 85) defined them as heterosexual, 27% (n = 38) as homosexual, and 12.7%
(n = 18) as bisexual. Sociodemographic data of BDSM practitioners and
the control group are given in Table 1. The prevalence of a psychiatric
disorder in the BDSM group was 20.6% (n = 29), and a history of
suicide was 17% (n = 24), while these results did not show a significant
difference compared to the control group. 54.6% (n = 77) of the
participants and 8.4% (n = 14) of the control group stated that they
had been discriminated against in the past while receiving medical/
psychological help because of their sexual practices (p < 0.001). In
addition, 62.4% of the participants (n = 88) and 15.6% of the control
group (n = 26) stated that they avoided seeking medical/psychological
help in the past because of their fear of being discriminated against due
to their sexual practices.
When the WHOQOL – BREF scores of BDSM practitioners and the
control group were compared, the overall QOL in BDSM practitioners
was 57.358 (s.d. 18.484), physical QOL was 46.96 (s.d. 11,317),
psychological QOL was 52.009 (s.d. 12,317), social QOL was 64,007
(s.d. 17,318), environmental QOL was found to be 48,847 (s.d. 17,524).
Physical, psychological, and environmental quality of life scores were
significantly lower than the control group (p < 0.001). The comparison
of BDSM practitioners and the control group in terms of WHOQOL
– BREF scores are given in Table 2. Among BDSM practitioners, the
QOL scores of those who stated that they were discriminated against in
the medical environment were found to be significantly lower in all subcategories (general, physical, psychological, social, and environmental)
than those who did not experience discrimination (p < 0.05).
CONCLUSIONS: The most important result of our study is that the
QOL in BDSM practitioners is lower than the general population in
terms of physical, psychological, and environmental aspects. In the
discriminated group, it is observed that there is a significant decrease in
the quality of life in all sub-categories.
The National Coalition for Sexual Freedom stated that 11.3% of kinkidentified individuals were discriminated against by a professional or
service provider, and 48.8% of those who practiced discrimination
were medical doctors. Although they do not differ from the general
population in terms of psychiatric and physical diseases, their lower
QOL on both physical and psychological aspects may be due to their fear
of discrimination. Since the BDSM community is in a more vulnerable
position in terms of physical and mental health as a sexual minority, it
is important that they can easily apply to health professionals in this
regard. The fact that social QOL values did not differ with the control
group suggests that the BDSM group has a strong social bond within
itself, but fear of being discriminated against affects individuals when
they are in the general society.
In order to improve the QOL of BDSM practitioners, it is important to
reduce discrimination against these people. It may be beneficial to give
importance to education on this subject in medical and psychological
settings and to carry out further studies on the BDSM community in
Turkey.