Importance of Medical Disclosure

When approaching a Master or Mistress, They will each have a list of requirements and prerequisites necessary for servitude. Fairly high on My list of demands is the disclosure of medical history. Tops of all sorts need to be able to gauge the risk and are often responsible for the well being of their bottom- any “damage” to be done should be well thought out, and the scope of which should be understood by all parties involved and not the result of carelessness or reckless behaviour. There is a risk involved with any form of BDSM even down to the simplest D/s relationship- you are in a position where someone else has power over you, and without notice likely will do something without consulting you. How then can such a practice be condoned-you ask? If the person in charge, ie Mistress, Madame, Master, Mommy Daddy, Teacher, whomever, is skilled and trained They know the proper methods for dolling out the most brutal of wonderful punishments, and pushing your body to its limits without dangerously exceeding them. Therefore I consider it absolutely essential for the open and honest communication of all prior medical constraints and possible problems to be disclosed prior to any physical, and most mental play.

It is a common misconception that the only “risky” forms of play are the more extreme plays, such as edge play, piercing play etc etc. This is untrue. They place you at a higher risk than other practices for only SOME of the potential dangers involved. The obvious here being there is blood and the possibility of physical trauma and permanent marks, and the spread of blood born pathogens etc. However those aren’t even the tip of the ice berg for THOSE types of play let alone play regarded as less risky, and the proper information training and experience are necessary to know when and where what caution should be exercised.

Medical training is easily acquired, from First Aid and CPR through EMT, CNA, RN etc etc and no one without appropriate licensing should be handling potentially hazardous bodily materials in the first place. Someone with adequate training should know how to appropriately maintain a sterile environment and prevent cross contamination, prevent infection and monitor vital signs during extreme play and how to restore the space, toys and tools and dispose of the barriers. I am also of the opinion that anyone interested even in basic play should be trained in at least community first aid and cpr. Just to throw some things out there, if you are an alcoholic (or habitual drinker who drinks more than 2 drinks a day and is male, or more than 1 drink a day and is female) or suffer from any other blood thinning disorders such as hemophilia, anemia, menorrhagia etc etc a simple cut or gash can bleed out more than anticipated, ausing shock or worse, or a real mess! The appropriate measures should be taken and if you are truly surrendering control to another person they need to be able to make the judgment call with the proper information from the get go. Any withholding of information is ultimately cheating and hurting yourself, and your play partner.

My motto: Don’t try it unless you know what you are doing: if you know how to do it and were properly trained you know who you are. That being said lets discuss some of the less “extreme” plays often overlooked that could end in disaster.
The example I like to give people is bondage, your average fun, run of the mill restraint scene. Whether it be full-on immobilization, or simply handcuffs to a bed post it is common and OK for your limbs to fall asleep, or get a little tingly. FYI your limbs dont need to be bound to fall asleep as I’m sure you are all aware (like crossing your legs). Constriction is ok too, for short periods of time. However consider Diabetes. Diabetics suffer from extremely poor circulation, constriction of a limb could therefore result in the need for amputation or in the loss of consciousness of your captive where an otherwise healthy person could have sustained the same force 3 times or worse and longer. Add to it epilepsy or a heart condition and you have yourself a sexy little corpse. Knowing the inherent risks involved in the activity itself just isn’t enough.

Cleanliness, sanitation and contientious disposal also should not be reserved merely for penetrative or subdermal equipment nor only equipment used in extreme play. There are clearly different levels of precaution that need to be used with different levels of risk, such as the need to autoclave instruments, or the need for single-use pre-sterilized needles, gloves and skin preps for extreme play… BUT what about your paddle, cane, whip or gag? There are plenty of diseases and viruses that can be communicated from skin to skin contact. The use of rubber, PVC/vinyl, and surgical or stainless steel increases the ease with which toys can be cleaned and reused. And remember, blood can *NEVER* be removed entirely from plastic, or fibrous materials- thats why plastic medical implements are single use, and paper gowns get thrown away. EG. Hepatitis can survive 1-3 months in NON-ideal settings and still be viable and communicable. Think about that. All toys should be thoroughly cleaned, disinfected and sanitized before use, and in between use on multiple people. Some good ways to improve sanitary conditions for yourself and your equipment is to always keep and use rubber or non latex gloves as a barrier, carry antibacterial hand sanitizers (most of which are leather and vinyl safe), ER spray, alcohol prep pads, toy cleaners (available at most if not all sex and toy shops), and to of course always use a condom or similar barrier device (rubber glove, dental dam) in any ANY penetratory activity, oral, anal, vaginal, urethral ANYTHING!!! and that means as a covering on toys too.

Among the most commonly overlooked dangers involved with BDSM D/s relationships is mental illness, trauma, the repressed fears from the anxiety, and other triggers felt while in submissive or dominant mindspace. This includes but is not limited to a serious history of mental illness such as Bi-polar disorder, Schizophrenia, Borderline Personality Disorder, and traumatic past events such as sexual assault, post traumatic stress disorder, and ANY hospitalizations for treatment of any of the above mentioned and the many many more out there. Persons in a dominant role should understand the basis and need for boundaries and respect them, not necesarily as final but as something to be worked on, worked over and hopefully through. BDSM is supposed to be fun, an expression of love or lust, skill, interest, and can be and should be extremely therapeutic and beneficial to those involved. That is why safe and consensual practice and play is always necessary and oversights and exceptions should not be permitted.

Basically, if you have been diagnosed with something, even if you dont think it is relevant what you don’t know, and what you PLAY PARTNERS DONT KNOW can hurt you. If you are shy or ashamed for some reason do some research, talk to someone in an anonymous fashion before approaching a Dominant for play. If you approach a Dominant and intentionally withhold this information you are a danger to yourself and others- and unfortunately every major injury, or godforbidDeath sets the community back another decade… . Isn’t it hard enough with the local laws in most states? Together we can make the world a kinkier and more fun place to play all day!

terms to learn:
SSC- Safe Sane Consensual
RACK- Risk Assessed Consensual Kink

~ by Klawdya Rothschild on November 9, 2008.

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