Sexual Satisfaction in BDSM

Yet again, dominant players in BDSM show a mental health advantage.

Posted May 29, 2019

BDSM (bondage and discipline, dominance/submission, sadism-masochism) seems to be a topic of immense fascination for laypeople and social scientists alike. In the past, the practice has been stigmatized as deviant, and a reflection of psychopathology, but there is now growing evidence that consensual BDSM practices may actually be a healthy way that many people express their inner sexual desires and fantasies. A recent study (Botta, Nimbi, Tripodi, Silvaggi, & Simonelli, 2019) examined sexual satisfaction and functioning among BDSM practitioners and found that not only do practitioners appear to be well-adjusted, some, particularly those who prefer the dominant role, appear to be more satisfied with their sexuality than non-practitioners. The reasons are not yet understood, but it may be because those in the dominant role have personality traits that are particularly conducive to good mental health.

A growing body of research has explored the psychological aspects of BDSM. I have reviewed a few of the relevant studies in previous posts here and here. BDSM encompasses a wide range of practices typically associated with control, humiliation, physical restriction, and role-playing (Botta et al., 2019). Typically, practitioners adopt particular roles during their activities, most commonly either as a “dominant” who exerts control over others, or a “submissive” who consents to be controlled. Some people have a fixed preference for either role, while some people are “switches” who prefer to alternate between these roles. The actual practices people may engage in are extraordinarily diverse, and while some practitioners may only engage in a few preferred activities, others may experiment flexibly with a wide array of scenarios. Although there seems to be a popular idea that BDSM is something only a few odd individuals engage in, surveys have shown that it is far more common: Between 10 and 50 percent of people surveyed have admitted to engaging in some form of it, and many more at least fantasize about it (Coppens, Brink, Huys, Fransen, & Morrens, 2019).

One study found that BDSM practitioners in some respects appeared to have better mental health than individuals in the general population, although when looked at in more detail, the findings showed that it was those who preferred the dominant role who enjoyed these particular benefits (Wismeijer & van Assen, 2013). For example, dominants had higher subjective well-being and lower rejection sensitivity than submissives or switches and a control group of people drawn from the general population. A more recent study (Botta et al., 2019) looked at sexual satisfaction and functioning, and the findings were comparable to those of previous studies, as it found that dominants seemed to be particularly well-off in terms of the study outcomes, although they found positive outcomes for switches as well, in contrast to previous findings.

The study recruited 266 Italian BDSM practitioners (141 men and 125 women) through ads on websites, Facebook, BDSM forums, and BDSM meetings. The control group consisted of 200 people with similar demographic characteristics. All participants answered questions about potential sexual complaints in the last six months, as well as their sexual satisfaction, and other personal information. Practitioners also indicated their preferred role during BDSM (dominant, submissive, or switch) and provided detailed information about their sexual behaviors and practices.

The study found that people engaged in a wide range of practices. The most prevalent fell in the category of dominance/submission, which were engaged in by over 90% of men and women. Sadism/masochism practices were noticeably less prevalent, engaged in by just over 50 percent of men and women. Despite this, practices involving physical pain (including giving or receiving) were popular with both men (73.8 percent) and women (90.4 percent), with women having a significantly higher preference. Additionally, bondage was moderately popular (men: 58.9 percent; women: 54.4 percent), as were humiliation (men: 56.7 percent; women: 59.2 percent) and non-permanent ownership signs (objects, collars, etc.) (men: 67.4 percent; women: 82.4 percent; a significant difference).

Regarding roles, physical pain was popular in all three groups, although this was somewhat more preferred in dominants (88 percent) and submissives (82 percent) than switches (72 percent), suggesting that dominants and submissives had a somewhat stronger preference for more extreme practices. There were also a host of what appeared to be niche practices, such as “pony play” (dressing up as a horse and being led around on reins), as well as too many others to go into, that were enjoyed by a minority of practitioners of both sexes, which shows the enormous diversity and creativity within BDSM. In line with previous studies, men were more likely to take the dominant role, and women the submissive, as shown in the diagram below. Additionally, about 43 percent of male practitioners and about 66 percent of females were in an “ownership/belonging” relationship. This refers to an arrangement in which the dominance/submissive relationship is more or less a full-time practice rather than restricted to specific “games.” In roughly two-thirds of cases, this corresponded to the person’s actual committed romantic relationship.

Scott McGreal
Source: Scott McGreal

Regarding sexual satisfaction, dominants of both sexes were more satisfied than both the control group and the submissives. Switches had higher sexual satisfaction than the control group only. Further, participants in ownership/belonging relationships were more satisfied than those who were not, especially when this relationship corresponded to their committed romantic one. (Whether the dominant partner in such relationships had higher satisfaction than the submissive partner was not specified.) Similarly, for sexual complaints, dominants of both sexes reported fewer sexual problems and less overall sexual distress than the control group or submissives. These findings are generally in line with previous findings that dominants reported better mental health in several respects than either submissives or a control group drawn from a community sample (Wismeijer & van Assen, 2013).

Wikimedia Commons
Pony play: one of the more unusual activities
Source: Wikimedia Commons

The authors of this study suggest that control (being in the dominant role) and versatility (the switch role) may increase sexual satisfaction and sexual health. Findings from previous research suggest that dominants may also have particular personality traits that are associated with better sexual health as well as better mental health generally. Specifically, in the study by Wismeijer and van Assen (2013), dominants were lower in neuroticism (a trait associated with a host of emotional problems) and rejection sensitivity and had higher subjective well-being than those in the submissive and control groups. Similarly, another study (Hébert & Weaver, 2014) found that dominants were lower in emotionality (a trait from the HEXACO personality model that is similar to neuroticism) and higher on extraversion and desire for control than submissives. Previous research has found that both low neuroticism and high extraversion are associated with fewer sexual problems and higher sexual functioning (Allen & Walter, 2018), as well as with higher subjective well-being generally (Steel, Schmidt, & Shultz, 2008).

It is worth noting that in the Italian study (Botta et al., 2019) that I have been discussing, both submissives and the control group scored in the normal range on the measures of sexual satisfaction and sexual problems compared to general population norms. Hence, the findings were not that these groups were particularly distressed compared to dominants, but rather that dominants were functioning unusually well. People who feel comfortable in the dominant role may have a higher sense of agency and self-confidence than those who prefer the submissive role, and even people more generally. This is consistent with my suggestion in a previous post that BDSM practitioners may prefer roles that suit their personalities rather than seeking compensatory roles that contrast with their usual personality.

The finding that switches had higher sexual satisfaction than the control group is new in that a previous study that examined switches (Wismeijer & van Assen, 2013) did not find any particular advantage for switches in terms of subjective well-being or neuroticism, with dominants scoring better than all other groups in that study. Hence, it may be worth investigating if the versatility of the switch role is associated with any advantages in other populations of BDSM practitioners.

Moreover, that people in an ownership/belonging relationship had higher sexual satisfaction than those who were not, especially when this was in the context of a committed romantic relationship, appears to be a new finding. Botta et al. suggested that people in such relationships might be freer from sexual stigma and benefit from a heightened trust and emotional connection. It could also be that people enter into such an arrangement when they see it as a good fit for their personal psychosexual needs. This would be consistent with the increasingly accepted view that BDSM activities are not a pathological aberration or an expression of difficulties with normal sex, but simply an alternative that some people find attractive (Richters, Visser, Rissel, Grulich, & Smith, 2008).

© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 


Allen, M. S., & Walter, E. E. (2018). Linking big five personality traits to sexuality and sexual health: A meta-analytic review. Psychological Bulletin, 144(10), 1081–1110.

Botta, D., Nimbi, F. M., Tripodi, F., Silvaggi, M., & Simonelli, C. (2019). Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM? The Journal of Sexual Medicine, 16(3), 463–473.

Coppens, V., Brink, S. T., Huys, W., Fransen, E., & Morrens, M. (2019). A Survey on BDSM-related Activities: BDSM Experience Correlates with Age of First Exposure, Interest Profile, and Role Identity. The Journal of Sex Research, 0(0), 1–8.

Hébert, A., & Weaver, A. (2014). An examination of personality characteristics associated with BDSM orientations. Canadian Journal of Human Sexuality, 23(2), 106–115.

Richters, J., Visser, R. O. D., Rissel, C. E., Grulich, A. E., & Smith, A. M. A. (2008). Demographic and Psychosocial Features of Participants in Bondage and Discipline, “Sadomasochism” or Dominance and Submission (BDSM): Data from a National Survey. The Journal of Sexual Medicine, 5(7), 1660–1668.

Steel, P., Schmidt, J., & Shultz, J. (2008). Refining the relationship between personality and subjective well-being. Psychological Bulletin, 134(1), 138–161.

Wismeijer, A. A. J., & van Assen, M. A. L. M. (2013). Psychological characteristics of BDSM practitioners. The Journal of Sexual Medicine, 10(8), 1943–1952.