Autoerotic asphyxial deaths: A medicolegal analysis of forty-three cases

F. M. Walsh, C. J. Stahl, H. T. Unger, O. C. Lilienstern, R. G. Stephens

Research output: Contribution to journalArticlepeer-review

Abstract

A series of 43 deaths of white men during autoerotic sexual activity have been reviewed and the results of this study have been related to prior reports of autoerotic deaths in the literature. The majority of the deaths occurred in young men, less than 25 years of age. Although the investigative and pathologic findings were consistent with accidental deaths in 36 cases, there was evidence suggestive of suicide in 3 cases, and in 4 cases the manner of death was undetermined. Transvestism was associated with this activity in one-third of the cases. The psychodynamics of autoerotic sexual activity, as well as the relationship to transvestism, have been discussed. Although this entity is well known among forensic pathologists who consider it an accidental manner of death, insurers are less inclined to provide accidental death benefits in these cases. There is a need for greater public awareness of this entity for it is believed that some of these deaths among young men may be prevented with appropriate psychiatric intervention. The recent widespread dissemination of pornographic literature and films depicting explicit, deviant sexual activity may contribute to knowledge of autoerotic practices among persons with underlying psychiatric illness. Because of an increase in sexual experimentation among young persons and because of an increased awareness among investigators of the entity of autoerotic asphyxial deaths, one may expect the number of reported cases to increase in the future.

Original languageEnglish (US)
Pages (from-to)155-182
Number of pages28
JournalLegal Medicine
VolumeVOL.1977
StatePublished - 1977
Externally publishedYes

ASJC Scopus subject areas

  • Genetics
  • Pathology and Forensic Medicine
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

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