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Guide/Chapter VI

What the research says

What studies say about people who practise BDSM, with the sample sizes, the limits of each finding and the misconceptions they contradict.

7 min read · 20 sources · checked in October 2026

Oil painting: notes, a magnifying glass and a desk lamp
In this chapter
  1. Well-being and personality
  2. No proven link with past abuse
  3. How many people, and why the figures differ
  4. The body, in brief
  5. The limits of the studies
  6. Neurodivergence: a lead, little data
  7. Myths
  8. What is established, what remains a hypothesis
  9. Further reading

For a long time, research on BDSM mostly looked for what was wrong with practitioners. It eventually got round to measuring what they are actually like. The results are fairly reassuring. They also have real limits, detailed below, because a reassuring result that is misread is still misread.

Well-being and personality

The landmark study is Dutch. Using online questionnaires, Wismeijer and van Assen compared 902 practitioners with 434 control participants. The practitioners were less neurotic (less prone to anxiety and negative emotions), more extraverted, more open to experience, more conscientious, less sensitive to rejection, and reported greater well-being. Only one trait went the other way: they were less “agreeable” in the sense of the Big Five personality model, in other words less inclined to be accommodating. The authors conclude that BDSM looks more like a leisure activity than the expression of a psychopathology1.

A Spanish replication published in 2024, with 1,907 people, found the main points again: more secure attachment, conscientiousness, openness and well-being; less neuroticism, rejection sensitivity and agreeableness. The psychological structure is the same as in non-practitioners2. An American study of 279 practitioners found no difference in empathy between dominants, switches (who alternate roles) and submissives3.

These studies compare groups at a single point in time. They do not say that BDSM makes people happy, nor the reverse. They are group averages: they do not make one kind of sexuality better than another.

The strongest evidence comes from Australia. Richters and colleagues interviewed a representative sample of 19,307 people aged 16 to 59 by telephone. Those who had engaged in BDSM in the past year had not experienced sexual coercion more often, and were neither unhappier nor more anxious; men who practised BDSM even showed less psychological distress than other men4.

The picture is not entirely rosy. A Finnish study of 186 members of SM clubs found more reported childhood sexual abuse than in the general population5, and an online survey of 1,219 people links childhood abuse with sadomasochistic tendencies6. These are volunteer samples, and an association does not tell you what causes what. The review of 60 studies by Brown and colleagues concludes that models which treat BDSM as a symptom have little support7.

How many people, and why the figures differ

In Australia, 1.8% of sexually active people had engaged in BDSM in the past year (2.2% of men, 1.3% of women)4. In Belgium, among 1,027 people representative of the population, 46.8% had engaged in at least one BDSM-related activity in their lifetime, a further 22% had fantasised about it, 26% said they were interested and 7.6% considered themselves practitioners8. Brown’s review puts fantasies at between 40% and 70% depending on the study, and practice at around 20%7.

These figures do not contradict each other as much as it seems. They do not measure the same thing:

  • the period: the past twelve months in Australia, a whole lifetime in Belgium;
  • the definition: one word, “BDSM”, or a list of 54 activities, some of them very mild;
  • the object: fantasy, occasional practice, regular practice or identity;
  • the context: a telephone interview in 2001 and 2002, a questionnaire in 2017.

The body, in brief

Pilot studies measured, during real sessions, a rise in cortisol in the person receiving (58 people, then 35 couples), changes in endocannabinoids and a higher pain threshold in submissives910. The mechanisms of subspace, the altered state some people describe during an intense scene, and of drop, the low that can follow, remain hypotheses. The details, with what is measured and what is assumed, are in What happens in the body.

The limits of the studies

Most studies recruit volunteers online, through websites or networks within the scene. The physiological studies by Wuyts’s team recruited from the Flemish BDSM community, mostly among club regulars1117. The people who respond are those who are comfortable with the subject, which can make the picture look better than it is. Samples are often small: 14 people for the attention study, 58 for the first hormone study. The people studied are mostly white, well educated and young7. Almost everything rests on self-reports and comparisons at a single point in time, which rules out talking about causes. Replications are rare; the Spanish study is one, and it holds up2.

Neurodivergence: a lead, little data

You often hear that BDSM is particularly well suited to autistic people or people with ADHD: explicit rules, detailed negotiation, sought-after sensations. Studies exist, but they are few and fragile.

Pearson and Hodgetts interviewed six autistic adults. They described the clear communication and explicit consent of BDSM as reassuring, and cited sensory exploration and the pleasure of stepping outside norms as part of its appeal12. Wignall and colleagues gave an online questionnaire to 413 practitioners of pup play, a role play in which you take on the behaviour of a puppy (see pet play): one person in two had a score suggestive of autistic traits, compared with around one in 44 in the general population. The authors describe the results as preliminary, and a screening questionnaire is not a diagnosis13. On ADHD, an online study of 160 adults with ADHD and 75 without found that the former more often rated paraphilic fantasies and behaviours as highly arousing, with differences the authors call “rather small”; it is not about BDSM specifically14.

The honest conclusion: it is a hypothesis, with weak data. No representative study allows us to say that neurodivergent people are over-represented in BDSM.

Myths

“It is the result of trauma”

The only large representative sample finds no more past sexual coercion among practitioners4. The studies that find more reported abuse involve volunteers and say nothing about cause56. Having experienced violence does not stop you from practising; it sometimes calls for more careful negotiation, for example about words or actions to avoid.

“It is violent by nature”

What distinguishes a scene from an assault is consent, not how intense the action is. In the sessions observed by Sagarin, gestures of care and affection were part of the activities, and successful scenes ended with less stress and more closeness9. When a stop is no longer respected, however, it is no longer BDSM: the law says so too (see Law).

“The dominant decides everything”

Limits are negotiated by both people and consent can be withdrawn at any time. In Hébert and Weaver’s interviews (9 dominants, 12 submissives), the dominants describe themselves as attentive and responsible, and cite the workload and the weight of responsibility among the difficulties of the role15.

“A safeword is enough”

No. After a scene, bottoms, the people receiving, do less well on an attention test, and submissives’ pain threshold rises1617. Less pain and less judgement: the safeword, the word agreed on for stopping, may not come. It is a safety net. Active monitoring by the person leading remains essential (see Consent).

“Fifty Shades of Grey is a model”

An analysis of the first novel identifies psychologically abusive behaviour in almost every interaction, and alcohol used to weaken consent18. Practitioners also criticise it for presenting Christian Grey’s tastes as a pathology to be overcome20, exactly the model that the studies above do not support. For the history of the phenomenon, see History.

What is established, what remains a hypothesis

Claim Level of evidence What it rests on
Consensual BDSM is not a disorder in itself Established ICD-11 and DSM-519
Well-being equal to or greater than that of non-practitioners Well supported, non-representative samples 902 + 434 people; replication with 1,907
Not linked to past abuse Supported by a national sample; contrary data from volunteers 19,307 people; 186 and 1,219 people
Interest in BDSM is widespread Established in Belgium 1,027 representative people
Cortisol and endocannabinoids change during a session Pilot studies 58 people; 35 couples
Subspace = partial standby of the prefrontal cortex Plausible hypothesis 14 people
Sub drop = hormonal crash Untested hypothesis No study
BDSM and neurodivergence Hypothesis, weak data 6 interviews; 413 and 235 online respondents

Further reading

  • What happens in the body: cortisol, endocannabinoids, subspace and drop, measured versus assumed.
  • History: how BDSM got out of the psychiatric classifications.
  • Consent: what negotiation needs to cover for the research above to hold true for you.
  • Portrait: the big questionnaire to map your desires and limits, practice by practice.

Sources

  1. Wismeijer, A. A. J. and van Assen, M. A. L. M., 2013. Psychological characteristics of BDSM practitioners. The Journal of Sexual Medicine, 10(8), 1943-1952. link ↑

  2. Lecuona, O., Martínez-Barajas, O., Gimeno-Martín, A. et al., 2024 (online), 2025 (issue). Not Twisted, Just Kinky: Replication and Structural Invariance of Attachment, Personality, and Well-Being Among BDSM Practitioners. Journal of Homosexuality, 72(6), 1079-1108. link ↑↑

  3. Jansen, K. L., Fried, A. L. and Chamberlain, J., 2021. An Examination of Empathy and Interpersonal Dominance in BDSM Practitioners. The Journal of Sexual Medicine, 18(3), 549-555. link ↑

  4. Richters, J., de Visser, R. O., Rissel, C. E., Grulich, A. E. and Smith, A. M., 2008. Demographic and psychosocial features of participants in bondage and discipline, "sadomasochism" or dominance and submission (BDSM): data from a national survey. The Journal of Sexual Medicine, 5(7), 1660-1668. link ↑↑↑

  5. Nordling, N., Sandnabba, N. K. and Santtila, P., 2000. The Prevalence and Effects of Self-Reported Childhood Sexual Abuse Among Sadomasochistically Oriented Males and Females. Journal of Child Sexual Abuse, 9(1), 53-63. link ↑↑

  6. Abrams, M., Chronos, A. and Milisavljevic Grdinic, M., 2022. Childhood abuse and sadomasochism: New insights. Sexologies, 31(3), 240-259. link ↑↑

  7. Brown, A., Barker, E. D. and Rahman, Q., 2020. A Systematic Scoping Review of the Prevalence, Etiological, Psychological, and Interpersonal Factors Associated with BDSM. The Journal of Sex Research, 57(6), 781-811. link ↑↑↑

  8. Holvoet, L., Huys, W., Coppens, V., Seeuws, J., Goethals, K. and Morrens, M., 2017. Fifty Shades of Belgian Gray: The Prevalence of BDSM-Related Fantasies and Activities in the General Population. The Journal of Sexual Medicine, 14(9), 1152-1159. link ↑

  9. Sagarin, B. J., Cutler, B., Cutler, N., Lawler-Sagarin, K. A. and Matuszewich, L., 2009. Hormonal changes and couple bonding in consensual sadomasochistic activity. Archives of Sexual Behavior, 38(2), 186-200. link ↑↑

  10. Wuyts, E. and Morrens, M., 2022. The Biology of BDSM: A Systematic Review. The Journal of Sexual Medicine, 19(1), 144-157. link ↑

  11. Wuyts, E., De Neef, N., Coppens, V., Fransen, E., Schellens, E., Van Der Pol, M. and Morrens, M., 2020. Between Pleasure and Pain: A Pilot Study on the Biological Mechanisms Associated With BDSM Interactions in Dominants and Submissives. The Journal of Sexual Medicine, 17(4), 784-792. link ↑

  12. Pearson, A. and Hodgetts, S., 2024. "Comforting, Reassuring, and…Hot": A Qualitative Exploration of Engaging in Bondage, Discipline, Domination, Submission, Sadism and (Sado)masochism and Kink from the Perspective of Autistic Adults. Autism in Adulthood, 6(1), 25-35. link ↑

  13. Wignall, L., Moseley, R. and McCormack, M., 2023 (online), 2025 (issue). Autistic Traits of People Who Engage in Pup Play: Occurrence, Characteristics and Social Connections. The Journal of Sex Research, 62(3), 330-340. link ↑

  14. Turner, D., Gregório Hertz, P., Biedermann, L., Barra, S. and Retz, W., 2024 (online), 2025 (issue). Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality. International Journal of Impotence Research, 37(3), 251-257. link ↑

  15. Hébert, A. and Weaver, A., 2015. Perks, problems, and the people who play: A qualitative exploration of dominant and submissive BDSM roles. The Canadian Journal of Human Sexuality, 24(1), 49-62. link ↑

  16. Ambler, J. K., Lee, E. M., Klement, K. R. et al., 2017. Consensual BDSM facilitates role-specific altered states of consciousness: A preliminary study. Psychology of Consciousness: Theory, Research, and Practice, 4(1), 75-91. link ↑

  17. Wuyts, E., De Neef, N., Coppens, V. et al., 2021. Beyond Pain: A Study on the Variance of Pain Thresholds Within BDSM Interactions in Dominants and Submissives. The Journal of Sexual Medicine, 18(3), 556-564. link ↑↑

  18. Bonomi, A. E., Altenburger, L. E. and Walton, N. L., 2013. "Double crap!" abuse and harmed identity in Fifty Shades of Grey. Journal of Women’s Health, 22(9), 733-744. link ↑

  19. Krueger, R. B., Reed, G. M., First, M. B., Marais, A., Kismodi, E. and Briken, P., 2017. Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11). Archives of Sexual Behavior, 46(5), 1529-1545. link ↑

  20. Wikipedia (English), accessed 2026. Fifty Shades of Grey, section on the critical reception. Wikimedia. link ↑