Autoerotic Death Research Articles

Forensic issues in autoerotic deaths: A 44-year systematic review and a case series from the legal medicine institutes of Bologna and Milan, Italy.

Autoerotic deaths, defined as accidental fatalities occurring during solitary sexual activities, show complex forensic challenges due to their different mechanisms and variable death scene presentations. This study combines a systematic review of global literature spanning 44 years (from 1980 to 2024) with a detailed case series analysis from the Legal Medicine Institutes of Bologna and Milan, Italy, to provide comprehensive insights into this phenomenon.The systematic review identified 67 relevant reports from databases namely Scopus, Web of Science, and PubMed. In parallel, a case series of 7 autoerotic fatalities was analyzed, highlighting victims' demographics, causes of death, and associated factors.Findings from 101 cases of autoerotic deaths included in the systematic review indicate a predominant prevalence of asphyxial deaths, with hanging being the most common method, followed by intoxication. The study underscores significant gender disparities, with men comprising most cases (n = 91), spanning a broader age range (12-87 y.o.) compared to women (17-48 y.o.). The findings are fully consistent with the Italian case series presented here, in which all the subjects were men aged 18 to 72 years, and the cause of death was asphyxia in 6 cases.Toxicological analyses played a crucial role in elucidating the cause and manner of death in most cases, yet their utilization varies widely, impacting data reliability and evaluation of the cause of death. Notably, the evidence of volatile substances, especially inhalants, creates an emerging area of interest with potential epidemiological and preventive implications. The systematic analysis revealed substantial variability in death scene characteristics and forensic procedures, emphasizing the need for standardized investigative protocols.This study highlights the multifaceted nature of autoerotic deaths and the importance of a holistic forensic approach encompassing death scene investigation, autopsy, and toxicological analysis. By enhancing the understanding and awareness about this phenomenon, this research aims to inform evidence-based practices in forensics, mitigate diagnostic uncertainties, and facilitate preventive interventions.

Retraction: A Case of Accidental Autoerotic Death by Hanging Linked to Erotic Photography.

[This retracts the article DOI: 10.7759/cureus.65087.].

Suicide by ligature strangulation and/or hanging inside a motor vehicle: a comprehensive review.

Suicide by ligature strangulation/hanging inside vehicles is uncommon, and only few cases have been reported in the literature. This study aimed to conduct a comprehensive review of reported cases of suicide by ligature strangulation/hanging inside vehicles, analyzing the features of the death scene, of the ligature and furrow, autopsy findings, and causes of death. The comprehensive review was performed following the PRISMA guidelines by using the most common scientific databases. According to inclusion criteria, a total of 20 cases of vehicle-assisted strangulation/hanging were reviewed: 13 cases were assessed as ligature strangulation resulting in 7 complete decapitations and 7 other cases as hanging. All victims were young or adult males, except for one 48-year-old female. Death was assessed as suicide in all cases, except for a possible accidental autoerotic death. In 8 cases, a history of depression or other psychiatric disorders was reported. Toxicological analysis were positive in 7 cases. Hard ligature materials (nylon, steel, plastic, hemp ropes) were used in most cases, but only 13 cases had a well-demarcated furrow. In 2 cases, no internal findings of asphyxia were found. An additional case of ligature strangulation inside a motor vehicle off is also presented, where no autopsy findings of asphyxia were observed, except for a broad pale furrow and monolateral conjunctival petechiae. This study highlights the challenges in classifying suicidal hanging and ligature strangulation in motor vehicles.

ASFIXIA AUTOERÓTICA – QUANDO A VERGONHA MARCA A CENA

Autoerotic death is defined as accidental death that occurs during individual and solitary sexual activity in which some type of instrument or apparatus was used to increase the victim’s sexual stimulation leading to an unintentional death. We present the autopsy report of a 50-year-old man presented for autopsy with a history of suicide by hanging. The characteristics of the victim’s clothes, the semen stains on the clothes, with the presence of toilet paper next to them, suggesting masturbation and the absence of a hanging groove due to protective foam used by the victim, allowed the reconstitution of the probable mechanism produced by the victim in his asphyxia with the help of a rope and an elastic band attached to the heel of a high shoe, which, when broken, would have produced the fatal accident. The description of this case is important to alert to the concept of autoerotic death and avoid the misinterpretation of the legal medical etiology, allowing accidental cases to be interpreted as suicides, or even natural deaths to be interpreted as autoerotic deaths without fitting into the concept of autoerotic death, which must always be an accidental death. Keywords: autoerotic death, autoerotic asphyxia, autopsy.

Unusual Autoerotic Death with Hanging Whole body up to Beams and Wrapping inside a Complex Designed “Hammock”

We reported an unusual autoerotic death of a 33-year-old man who died due to asphyxia.

Atypical Autoerotic Death Due to Insertion of a Foreign Body into the Urethra and Rectum

Autoerotic death is an accidental death during sexual pleasure, usually caused by a device or equipment used to enhance pleasure. Autoerotic deaths can be classified as typical or atypical. Typical autoerotic deaths occur due to asphyxiation by mechanical compression, while atypical autoerotic deaths occur by means other than asphyxiation. Narcissism-associated accidental deaths during tube and wire insertion into the urethra and rectum are extremely rare. The victim, a man in his 40s, was found dead at his home. Several tools for masturbation and wires for urethral and rectal insertion were observed around the victim and many pornographic videos were also identified. Family accounts and medical records indicated that he masturbated often by inserting plastic tubes and wires into the urethra and rectum. Moreover, the victim had a history of surgeries to remove foreign objects from the urethra and rectum as well as a history of psychiatric treatment. The autopsy results revealed no specific findings indicative of the cause of death. In conclusion, the investigators determined the cause of death as an atypical autoerotic death based on the death scene investigation, autoerotic sexual behavior, personal history, and autopsy results.

Asphyxiophilia as a predecessor of autoerotic death: a postmortem case report

Asphyxiophilia as a predecessor of autoerotic death: a postmortem case report

Fatal strangulation during consensual BDSM activity: three case reports

Autoerotic accidents are well-known occurrences in forensic casework. Reports about unintentional deaths in a sexual context involving other persons are much rarer. Three cases of fatal incidents related to asphyxiophilia during consensual BDSM activity are reported. Two men died while visiting a dominatrix, the third one in the presence of a male casual sexual partner. Paraphernalia associated with BDSM/fetishism were found at the scene in all cases. Autopsy findings were compatible with death by strangulation. The cases are compared with published autoerotic accidents and similar unintentional deaths involving other individuals. The difficulties concerning the forensic assessment and reconstruction of the cases are discussed.

Rectal explosion: a strange case of autoerotic death

Autoerotic deaths refer to fatalities occurring during individual, solitary sexual activity, in which some device, situation, or act is used to gain or boost the sexual arousal of the subject. Anorectal autoeroticism is an autoerotic paraphilic activity that pertains to the self-insertion of various objects into the anal canal and rectal cavity to gain or heighten the subject's sexual drive. Although most foreign bodies inserted into the rectum do not cause significant injury, the introduction of some objects into the rectum might have unpredictable and even fatal effects. In this paper, we describe an intriguing autoerotic case of a 35-year-old male who sustained an explosive rectal trauma as a result of the unanticipated bursting of an expandable rubber pipe stopper that he inserted into his rectum and hyperinflated via an air blow gun connected through a pressure pipe to a centralized air-distribution system. The man sustained a circular abruption of the rectum with partial avulsion of the abdominal wall, associated with bleeding into the abdominal cavity and chest wall, and died before admission to the hospital. A police investigation revealed that the victim was a regular contributor to several web forums dedicated to unusual sexual activities. This case raises awareness of the broadening spectrum of methods and experiments associated with autoerotic behavior. We also reviewed the literature pertaining to this topic and outlined some of the characteristics of atypical autoerotic deaths. Although certain autoerotic methods are relatively common, other unusual autoerotic techniques may present novel challenges within the medicolegal field.

Autoerotic Deaths in Hamburg, Germany: Autoerotic accident or death from internal cause in an autoerotic setting? A retrospective study from 2004-2018

IntroductionAutoerotic deaths are rare events. The death scene is often bizarre and the death unexpected, thus often requiring forensic autopsies. Our analysis will provide an overview of the expected range of causes and manners of death in cases of autoerotic deaths. MethodsA retrospective analysis was carried out on all scientific and forensic autopsies and postmortem examinations performed at the Department of Legal Medicine in Hamburg, Germany, over the period of 2004–2018. Results25 cases of autoerotic fatalities were identified over this 15-year-period or one to two cases per year, respectively. Autopsies were carried out on 23 of these cases. 16 (64%) of the cases involved autoerotic accidents and 7 (28%) from internal causes of death during an autoerotic act. Two cases had not undergone an autopsy. On average, those who were involved in autoerotic accidents had been younger in age (average age: 37 years) than the individuals who died from internal disease (average age: 61 years). Only one woman was involved. The most common cause of death in autoerotic accidents was strangulation (hanging: 8 cases, ligature strangulation: 1 case), followed by smothering of the respiratory tract (4 cases). Fatal intoxication was diagnosed in three of the cases. Fatalities with natural cause of death solely involved cardiovascular causes of death. ConclusionsAutoerotic deaths involved a wide range of natural and non-natural causes of death. The reconstruction of such unusual cases and detection of non-natural fatalities requires thorough investigation of the scene of death as well as a postmortem external and internal examination including a chemical toxicological and blood alcohol analysis.

Fatal \u03b1-PVP and amphetamine poisoning during a sauna and autoerotic practices

We describe the sudden death of a middle-aged man while having a sauna under the influence of α-pyrrolidinovalerophenone (α-PVP) (PM blood concentration: 0.8 mg/L), amphetamine (0.34 mg/L), and other drugs (buprenorphine, benzodiazepines), and engaging in solitary sexual activities. The drugs’ effects on the cardio-circulatory system and on body thermoregulation combined with the high temperatures are likely to have been central mechanisms leading to death. The high levels of adrenaline triggered by sexual arousal and the respiratory depression caused by buprenorphine, in association with benzodiazepines, may have also contributed to his death. This previously unreported type of accidental autoerotic death illustrates the risk of using amphetamine-like sympathomimetic drugs (e.g. cathinone derivates) in hot environments such as a sauna, and during sexual activities therein.

Carnal gratification goes fatally wrong: A case of autoerotic asphyxial death

Carnal gratification goes fatally wrong: A case of autoerotic asphyxial death

Autoerotica death as a result of compression asphyxia in combination with strangulate

Autoasia (erotic asphyxia) – a form of abnormal sexual activity related to the use of funds, limiting the access of oxygen to the lungs and to the brain to enhance sensations associated with sexual discharge. Is a quite dangerous practice because it may lead to unconsciousness and immobilization of a person. As a rule, Assil hides his occupation from others, even from the closest people, so the presence of this deviation becomes known only in the cases when such activity leads to death. Below is an example of autoerotic death by compressive asphyxia combined with strangulate.

Dying for Sex: Cultural and Forensic Narratives of Autoerotic Death Lisa Downing

This article explores representations of autoerotic death in a range of discursive fields: the media, forensic pathology, the psy sciences, literary fiction, and internet humour. It adopts a broadly Foucauldian approach to the study of the topic; i.e., rather than interrogating what sexual practices leading to autoerotic death mean , or what motivates people to experiment with these 'extreme' practices, it explores instead what attitudes towards autoerotic death tell us about normative cultural understandings of sexuality and gender. The article interrogates the ways in which gender norms and roles are at play in the apprehension of autoerotic fatalities, marking some of the men who die in this way as effeminate, failed men; while others are represented as hyper-masculine misadventurers. It also discusses why the rare female autoerotic fatality troubles assumptions about the nature and role of women. The biases guiding definitions of 'normal' and 'abnormal' sexuality and gender are thus revealed in particularly striking ways by moving the focus of interrogation away from the pathologised practices and the bodies they produce, and onto the discourses that pronounce about them.

Autoerotic deaths and low socioeconomic status

This article presents two cases of autoerotic death involving asphyxiophilia in which the victims were from the lower levels of society. This is in apparent contradiction to the previously assumed theory that such sexual deviations were mostly practiced by people from the more affluent classes of society. An analysis of these two cases demonstrates that such practices are not only the domain of privileged members of society and that the previous assumption is probably now outdated.

Autoerotic death due to electrocution.

Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

Current Reports on Autoerotic Deaths—Five Persistent Myths

Autoerotic deaths are defined as accidental deaths that occur during individual, solitary sexual activity in which some type of apparatus that was used to enhance the sexual stimulation of the deceased caused unintentional death. In the Western countries, the incidence of these deaths is of approximately 0.5 deaths per million inhabitants per year. In this paper, five myths about autoerotic death are explored. Myth #1: the manner of death in autoerotic death is usually accidental but could also be suicidal or natural (reality: by definition, all autoerotic deaths are accidental). Myth #2: autoerotic death can happen with a sexual partner (reality: by definition, autoerotic deaths are solitary activities). Myth #3: an escape mechanism must be found at the scene (reality: there is no escape mechanism to be observed at the scene in the majority of autoerotic deaths). Myth #4: all autoerotic deaths are related to asphyxia (reality: not all autoerotic deaths are related to asphyxia). Myth #5: masturbation is an important component of all autoerotic activities and therefore all autoerotic deaths (reality: evidence of masturbation at the scene is a rare finding).

Atypical suicides or the first undiagnosed autoerotic deaths in Europe?

Autoerotic accidental deaths (AAD) are increasingly reported deaths occurring during solitary sexual rituals used to enhance sexual excitement. The majority of these fatalities involve hanging or other form of self-inflicted asphyxia. The German medical literature, with the first recognized AAD published in the early 1900s, has antedated by decades the first significant AAD reports (1950–1953) in English. Early contributions in languages other than English and German are mostly overlooked in current AAD reviews, although AAD were recognised in some European countries as early as the 1940s and 1950s. For a variety of reasons, it is likely that, before the description of the first AAD in the medical literature, some asphyxia deaths have been classified as suicides with peculiar features, instead of as accidents resulting from life-threatening sexual practices. In the present study, we review and comment on three such atypical asphyxia deaths investigated in central Europe (Austria, Italy, Switzerland) during the period 1821 to 1927. The retrospective analysis of these cases revealed some circumstantial and individual features which nowadays could be linked to AAD, and disclosed the reluctance of medical examiners to analyse their motivational, and possibly sexual, background. The medico-legal approach to some autopsy findings of these cases also illustrates some controversial diagnostic issues regarding mechanical asphyxia, issues recurrently debated during the 19th century.

An autoerotic death in Korea

Accidental autoerotic asphyxia occurring during autoerotic activity is usually considered the unanticipated failure of a sexual stimulation device to induce hypoxia during solitary sexual arousal. Here, we provide the first reported case of autoerotic death in Korea. In the present case, a young man died from asphyxiation as a result of being suspended with his head in a plastic bag. The death was considered accidental and not suicidal. The diagnosis of autoerotic death may be difficult when typical features are absent.

Autoerotic Deaths

It is written in almost all articles on autoerotic deaths that these fatalities account for about 500 to 1000 deaths per year in the United States and Canada. However, contrary to the general belief, this incidence rate was not obtained through a study, but it is an estimation based on 30-year unpublished data from Canada and England. In the present retrospective study from 1985 to 2009, 38 cases of autoerotic deaths were identified in the province of Alberta (Canada). This number corresponds to an incidence of 0.56 autoerotic deaths per million inhabitants per year. The vast majority of these deaths are related to typical, predominantly asphyxial methods, such as hanging. The bodies were most commonly found in basements, bedrooms, and bathrooms. There is no clear evidence of a preferential time of day for these deaths, but there appear to be slightly more autoerotic deaths during summer. The incidence of autoerotic deaths is higher in big cities compared with rural areas. The previously published estimate of 500 to 1000 'autoerotic deaths per year should not be used for Canada. An incidence of 0.2 to 0.5 cases per million inhabitants per year is a better estimate of the incidence of autoerotic deaths. The incidence in United States should be reassessed using epidemiological studies.