Letter to the editor--A revisitation of the most common methods of autoerotic activity leading to death based on the new standardized classification of asphyxia

Electrocuted to death: A case of an autoerotic fatality with body wrapping, anal masochism, and low abdomen mechanical stimulation

Autoerotic paraphilic manipulations may be not only incredibly unusual but also hazardous and possibly fatal. Autoerotic experimenters sometimes combine several paraphilic mechanisms, both potentially lethal and non-lethal. A tragic outcome is usually a direct consequence of the life-threatening paraphilic mechanism(s); however, it may also result from an accidental complication arising from the constellation of the paraphilic realization. In this report, we present a case of an autoerotic death of a 30-year-old man who applied two potentially lethal paraphilic mechanisms-body wrapping and foreign body anal insertion-together with two other non-lethal paraphilic activities, autofetishism and transvestitism. However, the man's death ultimately occurred due to another associated autoerotic activity-stimulation of the lower abdomen with an electric massager, which accidentally short-circuited and caused fatal electrocution. Such autoerotic fatalities constitute a distinct subcategory of accidental autoerotic death.

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).

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.