Autoerotic Asphyxiation May Threaten More Kids Than Previously Thought

More children and teens than pediatricians realize could be participating in a dangerous, potentially fatal sex act known as autoerotic asphyxiation. So says Dr. Daniel Cowell, professor of psychiatry and senior associate dean for graduate medical education at the Marshall University Joan C. Edwards School of Medicine in Huntington, W. Va.

Autoerotic asphyxiation -- or AEA -- has been documented in the medical literature as far back as 1856. It is overwhelmingly more common in males, though female cases are not unheard of. It is an act that is usually performed when alone and involves reducing oxygen supply to the brain, usually by strangulation. The lack of oxygen leads to a sensation of giddiness or euphoria for some.

"In the medical community, I think it tends to be regarded, if it is regarded at all, as a medical curiosity, a freak behavior," said Cowell, who wrote a review article on AEA published Monday in the journal Pediatrics.

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In his article, Cowell contends that the practice could be much more common in children and teens than even those in the medical community realize. The problem, he said, is twofold: The first issue is that most of what is known about the practice is gleaned from the cases in which it leads to death. And the second is that those who practice it, particularly kids and teens, are seldom willing to talk about it.

"While it is estimated that there are 250 to 1,200 deaths per year in the U.S. from AEA, there is absolutely no way of learning how many practitioners there are with this potentially fatal behavior," he said, adding that some of these participants may be surprisingly young. "I know of cases as early as 9."

Other doctors agreed that the practice is a threat in younger age groups. "Adolescence is a time of exploration and experimentation as teens begin to develop their own sense of self," said Dr. Alanna Levine, a Tappan, N.Y.-based pediatrician.

"It is well known that teens experiment with alcohol, drugs and sex; however, it is difficult to make clear estimates about the number of adolescents engaging in AEA, as it typically occurs secretly, and it is also easy to mistake a death from AEA behavior for a suicide," she said.