Safe, Sane, & Consensual - the Relationship between Kink and Mental Health

For a long time, there has been a persistent public belief that “atypical” sexual behavior is an sign of mental illness and a risk for criminal behavior. We have seen this in many forms - from the pathologizing of LGBTQ+ identities to criminal cases in which consensual BDSM has been treated in the same way as non-consensual assault. While there have been some changes over time, such as increased acceptance and understanding towards queer identities, there are still many negative connotations around kink and those who practice it. These negative beliefs do not come out of thin air; in fact, there is a lot to be said about the role of clinicians in creating the idea that “sexual deviance” is abnormal human behavior and tied to trauma, poor sexual development, or addiction; sexual and paraphilic disorders have had a long history in the Diagnostic and Statistics Manual of Mental Disorders.

With that said, there are many people who experience healthy sexual relationships that include kink to varying degrees. Many clinicians and activists have called for new approaches to how we discuss kink and atypical sexuality in the therapeutic space. One of the most important pieces of bringing kink into a new light is providing people with education around prevalence, how sexuality relates to mental health, and how to practice kink in a safe, fulfilling, and pleasurable way. To start, let’s look a little more at some of the facts around kink.

Quick Definitions:


A term used to describe sexual acts deemed outside the societal “norm” of sexual behavior. The definition can be very dependent on differing individual and cultural concepts around what is “normal” sex. Some examples of kinks include: BDSM, roleplay, group sex, voyeurism, use of sex toys


A specific requirement needing to be present for an individual’s sexual gratification. A fetish could be an inanimate object (high heels, leather, latex), a specific body part (breasts, feet), or a type of partner. A fetish is different compared to a kink in that a fetish must be present for gratification, where a kink isn’t necessarily required for satisfying sex.


Bondage-Discipline, Dominance-Submission, Sadism-Masochism: An umbrella term encompassing a wide range of sexual activity that stem from themes of physical restraints, psychological power dynamics, and sexual pain. Examples of activities that fall under this category: use of handcuffs and/or rope, spanking with hand or object, erotic asphyxiation, roleplay involving power dynamics

How abnormal is it really?

One of the largest misconceptions around kink is that it’s usually happening in the context of sex clubs or dungeons between anonymous strangers in leather and latex. While for some people that’s what it looks like, there’s an overlooked majority who incorporate elements of kink into what are seen as “regular” relationships and sex lives. In fact, a lot more people are interested in it than one might expect - research has shown estimates of around 45% of adults showing an interest in at least one paraphilic/kinky sex act and around 35% of adults have engaged in at least one “non-normophilic” sex act. It’s not just the masked stranger in the back of the dungeon wearing a collar and leash - it’s probably also your neighbor.

Looking even further than just prevalence, it’s also important to note the type of people that show interest in kink. Research has noted no significant differences in gender when it comes to interest in kink and fetishes. When comparing sexual minorities with heterosexual populations, there is a trend of more kink interest and behaviors in LGBTQ+ folks, potentially due to increased acceptance of sexual exploration and historic presence of BDSM groups within the queer community.

Here are some more stats when it comes to kinky thoughts and behavior:

  • 93% of men and 96% of women have fantasized about some aspect of BDSM before
  • 45% of people report having a fantasy regarding a fetish
  • Group sex in various forms tends to be a popular fantasy, as well: 89% report fantasies around threesomes, 79% have fantasized about orgies, and 61% have fantasized about “gang bangs”

Is interest in sexual kinks and fetishes a sign of mental illness?

The short answer is no; research has not found any significant relationships between interest and participation in kinky sex and mental illness. This makes sense when you think of the statistics above - a large portion of the adult population has kinky desires and many folks also act upon these desires. There are also no notable differences in past experiences of trauma or abuse between people who have kinky sex and people who do not. People don’t engage with BDSM or other forms of kink due to mental illness or injury; most people try it because it’s fun, exciting, and sexy.

Kink can even be good for your mental health - the excitement of new experiences produces endorphins that can increase mood and many kinky folks say that exploring different sexual dynamics helps to relieve stress. For people who have experienced sexual traumas, they report being able to regain a sense of control through BDSM play and similar activities.

That all being said, it’s important to note that people who have experienced trauma or abuse might be more at risk for negative outcomes related to unsafe practices. Whether or not you or your partner(s) have experienced interpersonal violence, safety is the most important concern with any kind of sexual activity.

How do I practice kink safely?

Safe practices and potential risks can vary between different acts, so it’s always most important to educate yourself before trying something new. However, some important overarching things to understand:


Consent is necessary for any and all sexual activity, and it is especially important when engaging with any form of kink. Consent is a conversation to be had before, during, and after sex - partners need to discuss exactly what they are comfortable with. It’s a common practice for kinky partners to discuss “hard limits” (meaning any activities that you do not desire and do not consent to) and comfort levels prior to play.

A helpful acronym to understand consent is FRIES

Freely given

You can learn more about sexual consent at: Planned Parenthood - Sexual Consent


While consent is the most integral piece of sexual communication, it is not sufficient alone for safety. Partners should work to understand one another and create a sense of trust. “Safe words” are another important piece of communication around kink: they are words that are agreed upon by partners beforehand to either pause or completely stop sexual play.


You should educate yourself on any type of sexual play that you are considering trying. Educating yourself on safe practices will reduce risks of injury to you or your partner(s). You should never engage with any act that could result in injury without understanding the best ways to prevent injury and what to do if an injury occurs.


While kinky sex can be fulfilling and pleasurable, it can also take a lot out of us emotionally, mentally, and physically. “Aftercare” refers to time taken after sexual play to care or tend to needs for yourself and your partner(s). For some, this might mean cuddling while you catch your breath. For others, this may be tending to any minor injuries or a debrief of sexual play. No matter what it might look for you, always check-in with yourself and your partner(s) after sex!

Learn More

Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life

How Kink Can Be Used to Help Your Mental Health
Blog Post

Need to Know Resources if You’re Interested in Exploring BDS
Blog Post