Kink Play the Healthy Way

Since there is such a close link between bears and the fetish/ kink community, we wondered about whether there are any kink related health concerns we should be made aware of. And as always the wonderful Dr. George came through for us with tons of amazing and useful information on how to participate in bondage, gear play, watersports, fisting and sounding, the safe way.

So, let’s take it kink by kink, shall we? (And keep an eye out for a part 2 to this feature, coming soon!)

Bondage

When I’m teaching about this, the medical issue around bondage that I talk about mainly is the restriction of blood flow to the brain. Rope should never be used to encircle the neck. You should never be putting pressure on the neck, particularly the sides of the neck. It’s very, very dangerous. It can lead to changes in the rhythm of the heart.

The other issue I’ve encountered with bondage are falls. If you’re suspending somebody or taking somebody’s leg out, then their balance changes. If their arms are restrained, they may not be able to reach out in case they fall. You need to be aware of your surroundings and the floor and make sure it’s safe for people. If the person has balance issues, it’s really important that you do the bondage on the floor or on a bed rather than anywhere else.

You also need to be aware of the anatomy of the body. An area that is at high risk of nerve crushing is the shoulders, particularly when you’re doing what’s called a TK (Takate Kobe), which is a Japanese Shibari term for a chest harness used for chest suspension. If you get it placed at the wrong spot over the shoulder, it can crush the accessory nerve which can cause big problems.

The wrist is very vulnerable as well. You can crush the radial nerve at the wrist and you’ve got the ulner nerve at the elbow. On the leg you’ve  got the common peroneal nerve just below the knee on the outside of the leg. It too is vulnerable to crushing pressures.

If you’re doing bondage, it’s really important that you keep on checking in with your bottom and make sure that they can move their fingers and their hands. A simple check for the nerves in the arms is if they can make an OK sign. Can they touch their fingers together? Can they squeeze your hand and can they flap their wrist? If they can’t do any of those, you need to undo the ties immediately. If a limb goes pale white, it’s probably a restriction of the arteries and you need to check and see what what’s going on with the circulation of the arms. In the same respect, if the arms go quite red then that’s a sign of restriction of the veins and vascular flow and you need to have a look at your ropes to make sure that there’s no restriction of blood flow.

I recommend that people be trained in in bondage. Go to Shibari workshops and learn how to do it properly and safely. For wrist and ankle restraints, always make sure that they’re well padded. For ankles especially, make sure that you get the ones with the sheepskin on the inside, it reduces the chance of damage to the nerves in the ankle. This is important because it’s a bony area, the skin is super thin, and so it’s very easy to damage.

I would be very wary about suspending somebody who’s over 200 pounds. You really want to know your shit before you do any suspension with people, being aware that not everybody’s mobility is the same.

Latex and Leather Gear

Let’s just look at Latex first. Latex is a waterproof fabric. The way that we moderate our body heat is that when we sweat, the sweat evaporates off the skin, which leads to a drop in temperature of the skin. The sweat is part of it, but more important part is the evaporation of the sweat off the skin, which leads to a drop in temperature of the skin, which leads to dissipating heat out. When you put somebody in latex, they are no longer able to do that.

Someone’s body temperature can go up quite quickly wearing latex, particularly if they’re outdoors and in the sunshine. I’ve looked after enough people who have fainted in those settings because they couldn’t regulate their body temperature which resulted in their blood pressure dropping, and then they fainted.

If something like that happens, the first thing you should do is to open up the latex and let the person’s skin get access to the air and help them to cool down. Get them out of the latex if you can. Hydrate gently as well.

If you’re going to a day event, it is important to make sure that you carry an alternative outfit to change into or simply don’t wear full body latex. You might just choose to wear a latex top or singlet instead. The results can be quite serious otherwise.

 Internationally there have been a couple of people who died wearing latex, even in solo play scenarios. One person died because they tried on a different suit that wasn’t theirs. It was too tight around the neck and that led to decreased blood flow to the brain. They passed out and they were found dead at home. If you’re doing solo latex play, it can be very dangerous and you must always have things set up to ensure your safety. One thing that I say is if you’re playing in a dungeon or even if you’re playing by yourself and you’re worried, plug in your iPhone so it’s charging. Make sure that the screen is facing up so you can always summon Siri. You can say the, ‘hey Siri’ prompt and then, call an ambulance if necessary.

Also, if you’re not cleaning your suit after each wear or if you’ve got skin issues, there is a bit of a chance of fungal skin issues depending on how you get into your latex. There’s powder that makes it easier to slide in there, but powder can be a bit gloopy and clumpy when it gets filled with sweat. Other people might use lube to get in there. If you’re doing that or if you’re fucking in latex it is important that you wash off any lube that got onto your latex  because that lube, particularly if it’s a silicon or an oil based lube, will just stay against the latex and slowly destroy it.

The concerns that we discussed about being in full latex also apply to bring in full leather gear in terms of overheating and stuff like that. I struggle with full leather gear because I know that I overheat. Particularly when you go to things like Folsom, it’s very easy to be out in the sun and overheat while wearing leather. Think about what the weather’s gonna be like when you’re choosing your outfit. And if you’re gonna do full coverage, be prepared to take layers off if you’re gonna be in the in the heat.

Watersports

Chlamydia and gonorrhea can be transmitted through water sports if you’re drinking the urine. I’ve also had one patient who precipitated gout from drinking too much urine. Another interesting thing to think about is whether or not you work in a job where you get drug tested. A lot of drugs are excreted through the urine. If you drink the urine of somebody who’s used drugs, there is a chance that you will test positive on a urine drug screening.

Methamphetamine is generally excreted through the kidneys and through sweat. If you have hot, sweaty sex, your skin and body hair and head hair can get contaminated with methamphetamine, so if you get hair tested, that could turn positive. If you drink urine from somebody who’s got substances in their bodies, those substances will get into your body as well.

Make sure that your skin’s not irritated before initiating play and you can always wash the urine off, of course. If you’re putting somebody in latex and then pissing inside the latex, then that could lead to irritation of the skin. If you’re planning on drinking urine, make sure the person is well hydrated because that super concentrated urine can taste a bit yucky. But…people drink red wine and enjoy it, so to each their own!

Fisting

This is an advanced play sport. You have to be trained by somebody who knows what they’re doing. Fisiting is a mind game. Being a receptive fister, you have to go against a lot of your bodily reflexes that keep things closed and things of that nature. Some of the sensations can be very different and for some people, overwhelming. So, know what you’re doing. Play with people who know what they’re doing. And learn. You can always tell a good fisting top because when you look at their hands, they’ve got lovely short nails. That’s important. And be able to read your body. If you’re getting cramping after fisting, if there’s discharge from the bum after fisting, then it’s really important that you go and see your doctor.

There is a risk of bloodborne transmission of Hepatitis B (get vaccinated) because the act of fisting can be traumatic to the bum and to the hand as well. There is also a risk of transmission of HIV, syphilys and we’ve even seen Hepatitis C transmission in the fisting community.

Really important things to think about, if you carry your own pot of lube, don’t share your lube with other people because if there’s Hep C that invertedly got put into the lube, it could be transmitted to other people. Be really conscious of cross contamination. If somebody’s in a sling being fisted, don’t touch the chains of the sling. After you’ve finished playing, clean down the chains of the sling and anywhere that you’ve touched to make sure that you’re not contaminated with anything.

Fisting can lead to transmission of fecal things as well – Shigella, Hep A, for instance. If you get any diarrhea, fevers, bloody diarrhea, it’s important that you get checked out by a doctor.

If you are being fisted and get bloating, change and sensation in the tummy, blood coming out of the bum, puss coming out of the bum, or you just feel unwell or feverish a day or so afterwards, go and see a doctor. They need to check and make sure that there’s no perforation of the bowel. And that would involve an X-ray and some bloodwork, just to make sure that there’s nothing unusual going on there. It’s better to catch that early rather than later, so if you’re feeling unwell after a longer session of fisting, go and get checked out by a doc, preferably by a kink-friendly doc, because they know what to look for as opposed to your average mom and pop.

Sounding

Another advanced form of play. Make sure that your equipment is really clean because it’s going into the bladder. The bladder is considered sterile, so anything that you introduce into, near or around the bladder could lead to a bladder infection or a urinary tract infection.

Don’t use saliva as lube for the sounds. Plenty of people use saliva as lube. There is enough bacteria inside saliva to lead to a UTI. You need to use sterile lubricant. Be super super gentle. The sensations that some people really like are the sound going into the prostate. Typically the sound will pass through the urethra, pass the prostate and then potentially go into the bladder depending on how deep you go.

DO NOT sound with things like chopsticks, crayons, or anything that’s not actually designed as a sound. They don’t need to go up in there. If you’re going to do sounding, learn from somebody who’s an expert in it and use the proper equipment. Some sounds are made of platinum grade silicon and its really easy to clean those afterwards. If there is any lubricant on them, wash the lubricant off, then pop them in a bowl with the stuff that you use to clean baby bottles. You can use that to sterilize the sounds afterwards. Follow the instructions on the box and then you can clean the sound with a paper towel. (Bacteria can’t grow on a paper towel.) And then once it’s dry, pop it into a zip lock bag to protect it from dust and contamination. It’s very important that you look after your equipment.

If you get any burning, stinging, unusual sensations or pus coming out of the eye of the penis, you might have a urinary tract infection, so go and see a doctor and get checked out. If there’s any bleeding or you’re not able to pee, that could be because you’ve damaged the prostate, particularly if you can’t pee. In that case, go to the emergency department because they might need to put a catheter in while the prostate settles down.

Dr. George Forgan- Smith is an expert in gay men’s health dedicated to the bear, leather and kink communities which he serves faithfully in Melbourne, Australia. In addition to working at the Collins Street Medical Centre and creating tons of educational content for his social media accounts (links below), he is the creator of The Healthy Bear website which he uses to share vital health information pertaining to and about our community.

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***Disclaimer: You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.