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Dying for it: Bizarre autoerotic deaths (Part 2)

In my previous blog I examined some of the most bizarre autoerotic deaths reported in the medical forensic literature. Here are another five.

Case 1: Autoerotic death by aerosol propellant

Source: Medicine, Science and the Law. Personal details:  32-year old white US man. Single. Computer programmer.

  • Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.

Case 2: Autoerotic death by clothing

Source: Medicine, Science and the Law. Personal details:  25-year old Japanese male. Single.

  • Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.

Case 3: Autoerotic death by hanging (female)

Source: Handbook of Forensic Pathology. Personal details:  19-year old white female. Single. College student.

  • Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks


Case 4: Autoerotic death by vacuum cleaner

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis

  • Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.

Case 5: Autoerotic death by hydraulic tractor shovel

Source: Journal of Forensic Sciences. Personal details:  62 year-old US white male. Married. Farmer.

  • Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK 

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78

Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56

Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.

Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Dying for it: Bizarre autoerotic deaths (Part 1)

In previous blogs I have examined many different sexual paraphilias that have ended up in death for individuals engaged in such practices. Many of these are from autoerotic asphyxiation but also from other sexual practices such as electrophilia and anaesthesiophilia. Today’s blog takes a brief look at some of the most bizarre autoerotic deaths reported in the medical forensic literature.

Case 1: Autoerotic death by car

Source: Journal of Forensic Sciences. Personal details: 40-year old white US male airline pilot. Married and father of two children.

  • Bizarre death event: A man left his home at 6am in the morning and told his wife that he was going shooting in the country. He was found naked except for a large-link 10-foot chain harness secured around his body. (The harness was tied around the man’s neck in a moderately tight loop and bolted. The chain then went down his chest and was tied into another loop around his waist. This was tied to the bumper of the car) at 7.30am in the morning in a remote area crushed against the left fender of his car (equivalent of a VW beetle). The engine was still running, ignition was on and the driver’s door was still open. The steering wheel was tied so that it would go round in anti-clockwise circles. His clothes were in the boot of the car. Reconstruction of the events leading to his death showed that he was either being dragged round by the car or following the car producing feelings of asphyxia. When he had finished his sexual turn-on he had tried to approach the car door but had forgotten to undo the chain from the bumper. The chain had got tangled up in the car’s axle and the man was found strangled to death by the chain.

Case 2: Autoerotic death by hanging (male)

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single.

  • Bizarre death event: Early one winter’s morning, two joggers found a partially clothed man hanging from a tree five inches from the ground. He was hanging from a rope tied round his neck but also had two other loops of rope harness around his thighs which also encircled his chest. His neatly folded clothes lay two feet away along with lipstick and a jar of Vaseline. He was wearing a woman’s brown wig and a stuffed white bra. He also wore a pair of men’s red underpants, a pair of tights and a pair of high-heeled women’s shoes. He was also found to have a carrot protruding from his anus. Basically his seat harness slipped and he asphyxiated himself on the ropes.


Case 3: Autoerotic death by blankets

Source: American Journal of Forensic Medicine and Pathology. Personal details: 60-year old white US male. Single. Diagnosed schizophrenic and had various sexual compulsions. Well educated former teacher.

  • Bizarre death event: After being reported missing from work by his employer, a man was found dead rolled up in 14 different blankets which had been sewn together (the two outermost layers were found fixed with adhesive tape in various places which raised the possibility of murder). Inside the blankets he was dressed in two pairs of hotpants, a pair of long johns and a vest. The body was wet and his hands and arms were outstretched above his head. They found a plastic bag over his penis into which he had ejaculated. He was masturbating while inside the blankets but he had become too hypoxic and died. He was immobilized inside the blankets and was unable to free himself. Over the last few years he had bought an astonishing number of blankets by mail order (over 60 found in his apartment most of which seemed to have some ritual or obsessive meaning by the way were laid out. No pornography was found in the place.

Case 4: Autoerotic death by dental anaesthetic

Source: American Journal of Forensic Medicine and Pathology. Personal details: 59-year old white US male. Single. Antiques dealer

  • Bizarre death event: Found dead in his locked apartment. He was seated in front of a dental anaesthetic machine with the anaesthetic face-mask over his face. He was sucking on a rubber teat similar (but much bigger) than a baby’s feeding bottle. There were other anaesthetic machines around the apartment as well as a lot of sexual literature (magazines, photographs, paintings, manuscripts all concerned with his elaborate fetish some of which included photographs of himself in these situations). He was wearing a rubber type apron, three woollen cardigans, a woman’s blouse and two pairs of women’s trousers and a pair of women’s bloomers.

Case 5: Autoerotic death by electrocution

Source: Medicine, Science and the Law. Personal details: 36-year old UK male. Gay (with partner). Unemployed ex-television engineer

  • Bizarre death event: Man found dead with a wire cradle applied to his scrotum with another loop of wire (end folded over) inserted into his Vaseline-lubricated anus. The wires were connected to the two terminals that supplied the loudspeaker within the television. When switched on, these wires carried a current of 0.6 amps at 2.2 volts (a quarter of the current needed to light a small torch). The body had two significant injuries. One on the right side of his face (entrance mark of the current), and the other over the left side of his scrotum (where the loop of the wire had been). Unfortunately, one of the wires had broken off resulting in a cessation of the stimulating activity. The man looked inside the back of the open TV set and his face came into contact with an exposed metal cap which zapped 2500 volts through him. The metal cap was the only live part of the television set and it was this that killed him.

(Part 2 can be found here).

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Eriksson, A., Gezelius, C., & Bring, G. (1987). Rolled up to death: An unusual autoerotic fatality. American Journal of Forensic Medicine and Pathology, 8(3), 263-265.

Hazelwood, R. R., Burgess, A. W., & Groth, A. N. (1981). Death during dangerous autoerotic practice. Social Science & Medicine. Part E: Medical Psychology, 15(2), 129-133.

Hiss, J., Rosenberg, S. B., & Adelson, L. (1985). ” Swinging in the park”: An investigation of an autoerotic death. American Journal of Forensic Medicine and Pathology, 6(3), 250-255.

Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19(2), 190-193.

Leadbeatter, S. (1988). Dental anesthetic death: An unusual autoerotic episode. American Journal of Forensic Medicine and Pathology, 9(1), 60-63.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Minyard, F. (1985). Wrapped to death. Unusual autoerotic death. The American Journal of Forensic Medicine and Pathology, 6(2), 151-152

Rupp, J. C. (1973). The love bug. Journal of Forensic Science, 18(3), 259-262.

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Candle with care: A beginner’s guide to wax play‬

“I love hot wax. My wife loves to drip it and pour it all over my body. I have dipped my [penis] in the wax and the feeling during the dipping and the sex after was great. We did remove the wax from any part that was going to penetrate. I have a very high threshold for pain. I normally don’t use any painkillers for such things as root canal’s, extractions, stitches or road rash from motorcycle accidents. I don’t get turned on in the slightest from any of this I just don’t feel pain like everyone else. I think it is very normal to have this fetish. It is a major turn on to me. You might want to experiment with different types of wax. Some have a higher melting point than others. Oh we have and have realized she likes to use the waxes with the higher melting points. She loves to see me squirm but in a good way” (Wiki Answers)

According to Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices ‘wax play’ is a form of sexually sensual play that involves warm or hot wax typically dripped from candles or ladled onto the individual’s naked skin (the individual typically being sexually masochistic). He also claimed that wax play was often combined with other BDSM and/or sexual activities. Dr. Aggrawal also makes reference to ‘wax play’ in a short section on ‘navel torture’. More specifically her reports that navel torture involves “infliction of intense sensory stimulation and pain to a person’s navel. Examples are sucking or pulling the navel out (often with a syringe), dripping hot oil or wax into the navel, and poking pins into the navel”. The Wikipedia entry on wax play provides a list for those that want to attempt such practices. The article informed readers that:

“Pure paraffin wax melts at around 130 to 135 degrees Fahrenheit (54 to 57 Celsius). Adding stearine makes the wax harder and melt at a higher temperature. Adding mineral oil makes the wax softer and melt at a lower temperature. Soft candles in glass jars usually have mineral oil in their blend and burn cooler at around 120 degrees Fahrenheit (49C), Pillar candles are mostly paraffin and burn warmer at around 140 degrees Fahrenheit (60C). Taper candles have lots of stearine and burn hotter still at around 160 degrees Fahrenheit (71C). Beeswax candles burn about 10 degrees Fahrenheit (6 C) hotter than equivalent paraffin candles. Although there are many web sites that repeat the same advice that color additives make candles burn hotter, actual experiments performed by two different researchers show that this is usually not the case. Increasing the distance the wax falls by 1 meter will drop the temperature about 5 degrees Fahrenheit (3C) at the risk of splatter. If ordinary candles are too hot, a special wax blend with a high concentration of mineral oil can be heated to lower temperatures in a crock pot or double boiler”.

In the ‘safety notes’ section, the article reminds readers that wax temperature can range from simply ‘warm’ to ‘dangerously hot’ and can cause serious burns (and that wax play practitioners should be careful that wax doesn’t “splatter into the eyes”. Obviously, different masochists can withstand different temperatures depending upon their individual tolerance levels. It then goes on to say that:

“Wax may be difficult to remove, particularly from areas with hair. A flea comb or a sharp knife may be necessary for wax removal; use of a knife for this purpose requires special skills, though a plastic card can work as well. Applying mineral oil or lotion before play can make wax removal easier…Wax heated in any sort of pot must be stirred vigorously or there can be dangerous temperature variations. Some people may be allergic to perfumes and dyes. Whatever is above a burning candle can get very hot, even at distances that may be surprising. Candles may break and set fire to objects underneath or nearby. Wax is difficult to wash out of clothes and bed linens. People with certain diseases, skin conditions, or taking certain medications may require additional precautions”.

A few academic studies into sadomasochism have examined various niche practices including wax play. For instance, in a previous blog on psychrocism (individuals who derive sexual pleasure and sexual arousal from either by being cold) I quoted from Brenda Love’s Encyclopedia of Unusual Sex Practices that said:

“Exposure to intense cold creates a sharp sensation that is similar to other physical stimuli that produce tension. The mind changes its focus from intellectual pursuits to physical awareness. Many [sadomasochistic] players use cold contact to heighten awareness of skin sensations. They often alternate cold with heat, such as ice cubes and candle wax”.

More empirically, a 1987 study published in the Journal of Sex Research by Dr. Charles Moser and Dr. E.E. Levitt surveyed 225 sadomasochists (178 men and 47 women). The most commonly reported SM behaviours (in 50% to 80% of participants) were flagellation (whipping, spanking) and bondage (chains, rope, gags, chains, handcuffs). Painful activities (for instance, the use of hot wax, ice, face slapping, biting) were reported by 37–41% of participants, though more dangerous painful activities (burning, branding, tattooing, piercing, insertion of pins) were much less frequently reported (7% to 18% of participants).

A more recent Finnish study published in the Archives of Sexual Behavior by Dr. Laurence Alison and his colleagues reported fairly similar findings to that of Moser and Levitt. Again, the most popular activities were flagellation and bondage. Less reported SM activities were the most harmful harm (piercing, asphyxiation, electric shocks, use of blades/knives, fisting, etc.). These researchers also explored the variations in sadomasochistic activities, and wax play fell into the ‘typical’ pain administration group. These were:

  • Typical pain administration: This involved practices such as spanking, caning, whipping, skin branding, use of hot wax, electric shocks, etc.
  • Humiliation: This involved verbal humiliation, gagging, face slapping, flagellation, etc. Heterosexuals were more likely than gay men to engage in these types of activity.
  • Physical restriction: This included bondage, use of handcuffs, use of chains, wrestling, use of ice, wearing straight jackets, hypoxyphilia, and mummifying.
  • Hyper-masculine pain administration: This involved rimming, dildo use, cock binding, being urinated upon, being given an enema, fisting, being defecated upon, and catheter insertion. Gay men were more likely than heterosexuals to engage in these types of activity.

A 2002 follow-up study by the same team on the same sample of sadomasochists (also in the Archives of Sexual Behavior led by Dr. Pekka Santtila) reported that 35% of their participants had engaged in hot wax play. From these few studies it would appear that wax play among SM practitioners is relatively prevalent although there appear to be few data about how regularly wax play is engaged in.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Alison, L., Santtila, P., Sandnabba, N.K., & Nordling, N. (2001). Sadomasochistically oriented behavior: Diversity in practice and meaning. Archives of Sexual Behavior, 30, 1-12.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Moser, C. & Levitt, E.E. (1987). An exploratory descriptive study of a sadomasochistically oriented sample. Journal of Sex Research, 23, 322–337.

Norische (2008). Candlelight moments: Basics of wax play. Idaho BDSM. Located at:

Safer+Saner (2006). Wax play. Located at:

Sandnabba, N.K., Santtila, P., Alison, L., & Nordling, N. (2002). Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: A review of recent research. Sexual and Relationship Therapy, 17, 39-55.

Spectrum (2004). The Toybag Guide to Hot Wax and Temperature Play. Emeryville, California: Greenery Press.

Wikipedia (2014). Wax play. Located at:

The stranglers’ greatest hit: A brief overview of autoerotic asphyxiation

Hypoxyphilia (more commonly known as ‘autoerotic asphyxiation’ and less commonly known as ‘asphyxophilia’) is a rare and potentially life threatening paraphilia where a person seeks to reduce supply of oxygen to the brain during a heightened state of sexual arousal. Restricting the oxygen flow causes a build of carbon dioxide. This increase in carbon dioxide brings about feelings of giddiness and pleasure which when accompanied by masturbation can heighten the sexual sensations. Typically, this is achieved by chain, leather belt, rope noose or plastic bag either alone or with a partner and often results in death. Deaths occur due to the loss of consciousness caused by partial asphyxia. High profile deaths (by hanging) have included the Australian INXS singer Michael Hutchence, the US actor David Carradine, and the English MP and television reporter Stephen Milligan.

Although asphyxia from hanging has been described most frequently, a review of autoerotic asphyxiate deaths by Dr Roger Byard (Adelaide Women and Children’s Hospital, Australia) concluded that a wide variety of other lethal situations have been reported. Other hypoxyphilia variants that have been reported include: the use of plastic bags, chemical substance, food, electrocution, water submersion, and power hydraulics, etc.

There is some disagreement as to how common such deaths are. The American Psychiatric Association estimates that one in a million deaths are caused this way. The American FBI estimates there to be a mortality rate of 1000 deaths per year in the States. In a review of the literature, Dr Jane Uva (Wright State University, USA) estimated the mortality rate as being anywhere between 250 and 1000 deaths per year in the United States. Most hypoxyphiliacs are male with one Canadian study published in the British Journal of Psychiatry reporting only one of 117 accidental hypoxyphilic deaths as involving a female. In general, hypoxyphiliacs are white middle-aged males, although there are cases in literature of women or men up to 87 years of age.

There is limited data available but the goal seems to be to increase orgasm intensity. This bears some relationship with those who use amyl nitrate (which reduces brain oxygenation). It has been said that this type of behaviour may be a dangerous variant or manifestation of sexual masochism with its ritualised bondage themes. The person often keeps diaries and may watch themselves in mirrors or video record themselves. A German study of 40 accidental autoerotic deaths published in the journal Forensic Science International, reported that the bodies of hypoxyphiliacs are typically discovered naked and/or with genitalia in hand. Pornographic and/or other paraphilic material and/or sex toys are often present. Furthermore, the individuals will have ejaculated shortly before their death. The literature also shows that hypoxyphilia has also been associated with other paraphilias including masochism, transvestitism, bondage, and fetishism.

In one of the few studies of hypoxyphiliacs that are still alive, Dr Stephen Hucker (University of Toronto, Canada) surveyed over 100 participants via the Internet. He reported that 71% engaged in various masochistic activities, and 31% also took sadistic roles. Furthermore, 66% reported using bondage, 44% used clamps on themselves, 14% used electrical stimulation, and 37% self-flagellated. With regards to the act itself, the highest level of arousal was reported to be to obstruction of breathing. However, loss of control and loss of consciousness were also important in increasing sexual arousal. The lowest sexual arousal ratings were for pain and humiliation.

Finally, a recent review – again written by Hucker – in relation to the new DSM-V paraphilia classification, he surveyed over 100 practitioners who have expertise in treating paraphilic activity. Hucker recommended that the term ‘hypoxyphilia’ should be abandoned in favour of the term ‘asphyiophilia’ as there is little empirical evidence to indicate that the effects of oxygen deprivation per se are the primary motive for the paraphiliiac’s behavior. He argued that the behaviour is sexual arousal to restriction of breathing.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

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, 148-152

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, 371-377.

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, 64-73

Burgess, A.W. & Hazelwood, R.R. (1983). Autoerotic deaths and social network response. American Journal of Orthopsychiatry, 53, 166-170

Byard, R. (1994). Autoerotic death — characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1, 71-78.

Cooper, A. J. (1996). Auto-erotic asphyxiation: Three case reports. Journal of Sex and Marital Therapy, 22, 47–53.

Hucker, S.J. (2008). Sexual masochism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment. pp.25-263. New York: Guildford Press.

Hucker, S.J. (2011). Hypoxyphilia. Archives of Sexual Behavior, 40, 1323-1326.

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.

Martz, D. (2003). “Behavioral treatment for a female engaging in autoerotic asphyxiation”. Clinical Case Studies, 2, 236–242.

Tough, S., Butt, J. & Sanders, G. (1994). Autoerotic sexual asphyxial deaths: Analysis of nineteen fatalities. Canadian Journal of Psychiatry, 39, 157-160.

Uva, J.L. (1995). Review: Autoerotic asphyxiation in the United States. Journal of Forensic Sciences, 40, 574–581.