What the science says about BDSM and psychological wellbeing

What the studies say overall

The idea that practising BDSM reflects a psychological problem is not supported by the studies gathered here.

A large representative survey in Australia found no evidence that those who had practised it had experienced more sexual coercion or were more unhappy or anxious than everyone else, and one review concludes that people who practise it differ little from the general population in psychopathology (Richters et al., 2008; Dunkley et al., 2018).

A large survey of young people in China likewise found no differences in attachment styles between those who practised BDSM and those who did not (Li et al., 2024).

Several studies compare practitioners with non-practitioners and find, if anything, the opposite of the stereotype (Lecuona et al., 2025; Wismeijer et al., 2013). In Spain, those who practised BDSM showed more secure attachment, more openness and more wellbeing, and less neuroticism and rejection sensitivity (Lecuona et al., 2025).

Another study of practitioners and a control group found less neuroticism, more extraversion and more subjective wellbeing, and in a non-clinical sample of more than four thousand people, sexual interests, including sadomasochism, were barely related to psychopathology (Wismeijer et al., 2013; Brown et al., 2023).

A scoping review of sixty articles concludes that there is little support for models that treat it as a disorder and that people who practise it do not show more mental health or relationship problems (Brown et al., 2020).

The studies also show that it is a more common interest than is usually thought: in a representative sample from Belgium, almost half had at some point taken part in a related activity and a further share had had fantasies (Holvoet et al., 2017).

Among practitioners, more sensation seeking and more active coping strategies were observed, and in a survey of people in the United Kingdom, satisfaction in the relationship was associated with sharing those interests (Schuerwegen et al., 2021; Brown et al., 2026).

In a national survey in Norway, sexual satisfaction was associated with BDSM and role-play behaviours (Strizzi et al., 2022). A systematic review records changes in cortisol in submissive people after a BDSM interaction, which suggests that the physiological stress system is involved (Wuyts et al., 2022).

A survey in the kink community shows the other side: injuries related to these practices were not rare, and more than half of the people had not told their doctor (Sprott et al., 2021).

Where they disagree

There are no major disagreements, but there are gaps. The cortisol studies are few and their meaning is unclear: a hormonal change does not in itself say whether the experience is good or bad for the person (Wuyts et al., 2022).

Limits of the evidence

Almost all are one-off surveys and many recruit from communities of practitioners, so they reflect those who choose to take part (Sprott et al., 2021; Wismeijer et al., 2013; Schuerwegen et al., 2021). They measure what each person reports and cannot tell us what causes what.

The studies concern consenting adults; they say nothing about non-consensual practices.

The studies, one by one

We have gathered 13 verified studies. Each summary is our own; the quotation in inverted commas is taken word for word from the original abstract, in English.

Other topics in the library

• Sex toys for couples9 studies
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