All Tied Up: The Stigma and Biases Surrounding BDSM and Kink for Mental Health Providers

Due to the DSM diagnosis category including mental paraphilia, there has been a question of whether or not BDSM/kink is linked to pathology (Moser et al. 2005). Kink refers to unconventional sexual practices or desires. BDSM is an overarching term that refers to a spectrum of sexual behaviors and preferences that incorporate (B)ondage, (D)iscipline (or Domination), (S)adism (or submission), and (M)asochism. The biases and stigma towards BDSM and kink have shown to be detrimental, as research has found that many BDSM and kink identified individuals are not out due to the fear of stigma and concerns regarding clinician beliefs. This is the case regardless of having specific needs relating to their kink behaviors and preferring to be out to their providers (Waldura et. al 2016). Therefore, the current aim of this project is to broadly explore therapists’ understanding and attitudes towards BDSM and kink through semi-structured interviews. IRB approval was obtained and we recruited 10 practicing clinicians using Psychology Today. Consistent with the qualitative research tradition of eliciting diverse responses, we identified individuals from diverse backgrounds. Additionally, we selected participants who listed sex therapy or kink-allied work in their bios as well as those who have no link to these key terms. Participants were asked to provide informed consent and participate in a 30-45 minute interview via Google Meets. All interviews were audio recorded and transcribed verbatim. Data was analyzed using thematic analysis procedures outlined by Braun and Clarke (2022). Thematic analysis has been used to identify, analyze, and report patterns in the data. We identified several themes that give us a better understanding of how therapists’ react to specific dynamics, and what would make them more comfortable in working with BDSM-and-kink identifying individuals. This exploratory research allows us to better assess future steps needed to work towards BDSM and kink normalization to enhance treatment effectiveness and allow therapists to provide more individualized care for their clients. Additional implications will be discussed.