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While some sexual practices can be considered physically dangerous in a general way (e.g., sadomasochistic behaviors or engaging in sexual activity with a horse1), sexual asphyxia stands out as having the clear potential to result in a lethal end. Various autoerotic practices can be seen to pose some inherent danger, such as the use of electricity (Brokenshire et al, 1984; Tan and Chao, 1983), vacuum cleaners (Imami and Kemal, 1988), and the insertion of objects into the rectum (Byard et al 2000). Autoerotic asphyxia, though, appears to present the most obvious risk of death to the practitioner. Although asphyxia can be accomplished through a variety of mechanisms (Ikeda et al, 1988; Leadbetter, 1988; McLennan et al, 1998; Minyard, 1985; O’Halloran and Dietz, 1993) that result in decreasing the flow of oxygen to the brain, this chapter concentrates on asphyxia induced via a constriction of the neck.
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