One of the most misunderstood areas of human sexuality is paraphilia, and specifically the realm of BDSM/fetish sex. Although the fantasies and activities that fall under the BDSM umbrella are frequent fodder for media scandals and sensational movies, frank dialogue about why people enjoy these variations is hard to find. Instead, many people feel guilty and ashamed that they have abnormal sexual desires, and worry that their fantasies imply that they have serious psychological problems.

While not as organized yet as the Gay & Lesbian movements, the BDSM/fetish communities have become an active political and social force in recent years. Thousands of websites currently host BDSM/fetish content, and hundreds of support groups and educational organizations have sprung up to accommodate the burgeoning communities of kinky folk. From a seemingly small, secretive subculture, the BDSM/fetish world has emerged on the Internet as a thriving open culture. Off-line, however, not that much has changed in the public's negative perception of kinky sex and the people who have it. This section of sexualhealth.com aims both to educate readers seeking to understand more about BDSM/fetish sex, and to offer sympathetic, non-judgmental advice to all who have questions and concerns about its safe practice.

As a clinical sexologist and author who has interviewed and counseled thousands of people over the years, and as a BDSMer myself, my perspective on sexuality and what is "normal" can be neatly summed up as follows: normal sex is whatever consenting adults find pleasurable. If you are of legal age; if you understand exactly what you're getting into sexually and feel good about it; if you can find another charming adult who shares your interests; and if you practice safe sex and take all other reasonable precautions to prevent STDs and unwanted pregnancies, then you aren't just normal, you're blessed.

Of course, this doesn't mean that the same things are normal for everyone. Peoples' sexual imaginations and impulses are incredibly diverse. Just as you wouldn't expect the whole world to agree on which color is prettiest or which flavor of ice cream tastes best, different people need and want different kinds of experiences in bed. Some of these experiences may not turn you on; some of them may strike you as downright weird; but all of them are perfectly acceptable, as long as the people who are actually engaged in it feel happy with their choice.

So what is BDSM? A short list of the types of fetishes and interests which fall under this heading includes: bondage, spanking, cross-dressing, transgenderism, role-playing, corporal punishment, sadomasochism, foot and shoe fetishism, golden showers, enemas, age play, infantilism, rubber fetishes, master/slave relationships, sexual dominance & submission, and dozens more kinks and fetishes that involve one person being in control and the other person surrendering control.

Most important to know is that when I talk about BDSM/fetish sex, I mean kinky intimacy between consenting adults. The concept of adult consent is critical to understanding BDSM. On the surface, an outsider may view an adult spanking or more extreme acts, such as a piercing or whipping, with the horror one feels at witnessing an assault. The outsider may equate rough sex with assault, and then assume that it is an act of anger or emotional coldness. It is therefore crucial to understand the underlying dynamic of BDSM lovers.

Here are several points to consider:

--BDSMers are as romantic, loving, and committed to relationships as anyone else. But instead of finding a kiss romantic, they may find wearing someone's collar to be romantic. Or a spanking may excite them more than conventional foreplay, and enhance their love for their partner.

--To a masochist, extreme sensation is perceived as pleasurable. You may compare it to a runner's high: the more intense the activity, the more their endorphins pump, and the more ecstatic they feel.

--A person who takes the submissive role is neither passive nor a victim. He or she has made a conscious decision to pursue BDSM and has probably looked long and hard to find a compatible dominant partner.

--BDSMers make explicit agreements about what they will and will not do together. Many use communication tools to ensure that they never overstep each other's boundaries. Examples of these include "safe words" (a word or phrase the submissive may utter when he or she wants an activity to end); "contracts" (written agreements outlining each partner's needs, desires, and expectations); and "negotiation" (the process of deciding what kind of relationship the partners want, and what level of commitment each will make). See A short lexicon of BDSM terminology for more terms.

--Dominance and abuse are as different as loving intercourse and rape. BDSM involves consenting adults who expect to derive pleasure from their experience.

--BDSMers may be aroused by "regular" sex too, but the BDSM acts give them the higher level of sexual satisfaction that they need to feel emotionally balanced.

--Not all submissives enjoy pain and not all dominant enjoy giving pain. Many BDSMers are only interested in sensual play, psychological domination or fetishes.

--Being into BDSM does not imply any psychological or emotional problems. BDSM is only a problem when an individual feels depressed or anguished about his or her sexuality.

--BDSM/fetishism cannot be cured. They are not diseases, for one. These desires are innate to individual sexual identity and usually persist throughout one's active sexual life. Counseling can only help people to accept their needs and to make healthful, positive choices.