3 min

Scarfing risks and safety tips

The allure of auto asphyxiation

Dear Dr Ren,

I’m a 24-year-old guy who has started dating someone who is into scarfing or auto asphyxiation. I didn’t know anything about this except the headlines in the newspapers about people found dead with ropes around their necks and their pants around their ankles. But I also hear that school kids are doing this as a game.

I agreed to do this to him and saw how excited it made him, but I am afraid to let him do this to me. I’d love to feel the rush he describes — “like having sex on ecstasy” — but I’m nervous.

Can this be safe as long as you have someone else there with you? What do I need to know?

Scarfless So Far

Dear Scarfless,

You are right when you say the media is not delivering accurate information about autoerotic asphyxiation (AeA). On one hand we read shocking, embarrassing headlines about celebrities (David Carridine, INXS singer Michael Hutchence) dead from AeA, while listening to educators decry the proliferation of the choking game. Is this a kids’ game or a highly dangerous sexual fetish?

What is it? Scarfing, also called asphyxiophilia, autoerotic asphyxia, gasping and breath control play, is the intentional restriction of oxygen to the brain during sexual arousal. It is accomplished by hanging, suffocation with a plastic bag, choking with a ligature or another person’s hands, gas or volatile solvents, chest compression, or some combination of these.

Who does this? Currently, there is no typical profile of a scarfer. AeA has been practiced by all genders and across many cultures for hundreds of years. It typically begins in adolescence and is practiced lifelong, judging from the age of most of its victims. We believe that males outnumber females by about 50 to 1, but because of the secrecy surrounding this behaviour, our only hard statistics come from death records of those who have succumbed.

Death? What about death? Fatalities occur with a frequency of about one per million of the population per year in North America, but note that this figure is based on cases that have been recognized as AeA. Many fatalities are listed as suicides. The most common victims are white males under 55, with teenage boys currently vying for that distinction. Death occurs when the victim miscalculates his state of hypoxia with the time required to achieve orgasm, a malfunction of the mechanical apparatus used to cut off the oxygen, or the failure of the self-rescue device.

What’s the appeal? The neck is home to the carotid artery, which carries blood to the brain, and the jugular vein, which carries it back to the heart. If you constrict these vessels, carbon dioxide builds up in your brain, creating a narcotic effect. Combining that with an orgasm may trigger a dopamine release that intensifies the euphoria even further — the “sex on ecstasy” effect your boyfriend describes.

Can it be done safely? AeA is risky, no way around it. You will have to weigh your risk/benefit ratio to decide if this behaviour is for you. Start slowly with simple breath play, and always be clear-headed and accompanied. If you are going to play with this dangerous toy, learn how to do it safely.

The risks include not only death but also damage to the brain caused by oxygen starvation. For some, the danger is part of the appeal — and when psychological attraction marries heightened physical response, auto asphyxiation’s allure becomes even more powerful. If you find you are a fan, or to protect your new lover, you need to know some safety measures.

First, some methods are safer than others. Cutting off blood flow with your hands is even more dangerous than cutting off breathing, since the oxygen flow to the brain falls much faster.

Understand that scarfing is almost always a solitary behaviour because of its associated taboo. That’s how things can go so terribly wrong. Having a partner present reduces the chance of accidental death by strangulation. Do NOT do this alone!

Happily, your new squeeze has shared this interest with you. He probably knows lots about it. Ask him to share his knowledge, or learn together, perhaps an anatomy and a CPR course. As with any high-risk behaviour, you need to be informed, aware and willing to accept the consequences, which, in this case, can be enormous: brain damage or death. Do not trifle with it.

Nevertheless, chasing the ultimate sexual high is seductive indeed, and many are enjoying the rush and aftermath of breath play.

In 2008, one study found that almost 80,000 students had practiced the choking game. A 2006 study found that more than 10 percent of 12-18-year-olds and almost 20 percent of 17-18-year-olds had participated.

Remember, these youths are not yet linking the high of hypoxia to sex and orgasm, a connection likely close at hand. This may generate the availability of better information but until then it is up to you to get and stay educated and be scrupulously careful.

As with any other risky activity, use your good judgment. And in this case, always travel with a friend.