"I'm Afraid to Go to the Emergency Room"

The Differences Between BDSM and Abuse

Maine Hospital Procedures for Alternative Lifestylers in Need of Emergency Medical Care


Information for Hospital Personnel Regarding Alternative Lifestyle Patients and Their Injuries

A Collaborative Effort of CUFSmaine and Your Area Hospital


Personal note: 

In the past year, I have been hearing from an increasing number of BDSM, gay, lesbian, and alternative practitioners who have been injured during play (or injured after play) but have avoided hospitals due to fear and misinformation.  They fear arrest, being subjected to mental health evaluations, or having DHS interfere in their lives.  The fears are very valid, especially with all the bad press the BDSM community is getting of late.

Since spring of this year, I have been working to gather information, educate medical personnel (as well as domestic violence services) throughout the state of Maine, and find answers to some of the fears stated by members of our community.  It has been hard, but rewarding work.  Believe it or not, we ARE making strides toward educating people about the BDSM community and our needs as patients.  In my research and interviews, I have met with some shock, a lot of positive curiosity, but no hostility.  We are gaining ground in the war against ignorance.

It is my sincere hope that the following information (which is available as a pamphlet to lifestylers, hospitals, and social service agencies - e-mail CUFSmaine for information) will alleviate some of the fears and distrust of the medical community.  

        Be well, 

        Mistress Ren


Questions and Fears of Alternative Sexuality Practitioners Regarding Emergency Room Procedures.

Will I, or my partner, be arrested for engaging in unusual consensual sexual activities?

As long as both parties involved are over the age of 18 and all activities, even those that caused the injury/illness, were consensual, you will NOT be reported to the police. Police are only called if one partner wishes to press formal charges against the other for assault, etc. Maine state mandatory reporting involves only minors, the elderly, and persons who are unconscious or incapacitated where there are questions of abuse.

Will I, or my partner, be reported to DHS, mental health agencies, or the local domestic violence advocacy?

No … not if both parties involved are over the age of 18, not elderly, and all activities were consensual. Domestic violence services or the hospital social worker may be called to the emergency room if the injured partner is unconscious, incapacitated, or under the influence of drugs/alcohol. The advocate will wish to speak to the uninjured partner to determine the cause of injuries. A truthful answer regarding the cause of the injuries will save time and grief.

Am I at risk for losing my children?

Not unless your children were involved in or witnessed the BDSM activity. Like all sexual activity between adults, what you do in your bedroom, away from the eyes of your children, is your business.

Will my family be notified?

If you are over 18, and request that they NOT be told, the hospital will honor your request. You decide who will and won`t be notified. HOWEVER, if you are unconscious, incapacitated, or under the influence of drugs/alcohol, a family member will be notified.

Will my insurance company be told how I was injured?

Unfortunately, yes. Many insurance companies require a copy of physician's notes or dictation in order to process your claim. However, speak to the physician treating you…s/he may be able to word their dictation/notes delicately so as to avoid further embarrassment and questions.

Will they refuse to cover me?

This is a question only your insurance company can answer. Your best option is to talk to your insurance carrier. You don`t need to mention BDSM, but get a good sense from them about whether or not they will cover accidents caused while participating in sports or in strenuous activity. Make sure there are no hidden agendas regarding self-inflicted injury.

Will the Emergency Department Staff make fun of me?

 Emergency personnel have literally seen everything imaginable. While your injury may seem extremely embarrassing to you, it is usually routine to the E.R. staff. Hospital personnel are trained to be non-judgmental and sensitive to the patient, no matter what the situation. You may see a few raised eyebrows and curious looks, but that is only human nature. IF any hospital personnel treat you rudely or insensitively, ask to speak to a supervisor, or contact the head of the department with your complaint.


(Personal comment from Ren - Hospital personnel are NOT Gods....they, like their patients, are human beings.  They put their pants on one leg at a time.  Yes, they went to medical/nursing school....yes, they worked hard for their degrees...yes, they command a lot of respect.  But you know what?  As a human being, you deserve respect also.  

If a member of the medical community doesn't treat you with courtesy, respect, dignity, and compassion - COMPLAIN!  You complain when a waitress treats you badly, right?  Like waitresses, medical personnel are providing a service - compassion is part of that service.  They are there to serve and assist YOU.  

You HAVE THE RIGHT to complain about shoddy treatment from a hospital employee ... you have the right to request ANOTHER physician or nurse.  Use your rights.  Inform the head of the emergency department - insist that the offending personnel be reprimanded.  Then, inform the hospital administration offices and public relations offices of your complaints.  Hell ... call the CEO's office. 

If BDSM, alternative, gay, and lesbian patients DON'T complain when they are treated badly, the discrimination continues.  Speak out, stand tall, and make your rights as a human being known.)


 Will the physician/hospital keep my lifestyle private?

Physicians are bound by law to maintain confidentiality with their patients. Records and information of your treatment will not be made available to the general public or your family (if you request). However, records are circulated between hospital departments for treatment, and also to insurance companies for payment.

Will copies be sent to my private physician?

Only per your request.


Tips from Emergency Physicians 

Tell the truth

This was the #1 piece of advice from all hospitals and physicians we spoke to. Be upfront and honest about how you were injured!

The medical staff isn`t there to judge your lifestyle - they are there to evaluate your injuries. Admitting alternative sexuality activity is embarrassing…but five minutes of embarrassment is better than hours of interrogation by DHS if you try to hide the cause of your injuries.

Tell your primary physician of your activities

Some member of the medical community should know your lifestyle in case of extreme emergency. Also, telling your primary physician allows him/her to better treat you and your injuries or illnesses.

Don`t come to the emergency room for minor injuries.

Use the emergency room for emergencies - chest pain, difficulty breathing, bleeding that will not stop, broken bones, allergic reactions, severe burns, heatstroke, diabetic reactions, seizures, and any kind of injuries to the face, hands, feet, or genitalia. Otherwise, see your primary care physician.


Information For Hospital Personnel

 Imagine this: You are working at home and severely injure your back. Your spouse/partner wants you to go to the doctor`s office or the emergency room. You refuse. Last night, you and your spouse/partner engaged in alternative sexual activities that left marks upon your body - marks you consented to. You refuse medical treatment and choose to suffer silently rather than risk humiliation and the perceived possibility of being reported to social services.

 Another scenario: During alternative sexual activities, you accidentally get hurt. You are petrified of going to the hospital for fear of you or your partner/spouse being arrested. What do you do?

OR…you are fearful that your partner will be mistaken for a batterer and you, his victim. The thought of being interrogated by emergency staff and social services prevents you from seeking the medical attention you need.

 Unfortunately, these scenarios happen every day. This section contains the information you, as the medical professional, need to distinguish the differences between consensual alternative sexual activities and abuse.


Questions for Medical Professionals

 Are these bruises/injuries/etc. the result of 'safe, sane, and consensual` activity?

The phrase "safe, sane, and consensual` forms the basic 'law` of BDSM…most people (although not all) involved in BDSM activities know this phrase and will respond to it. It is an excellent tool to use to differentiate between BDSM practitioners and abuse victims.

 Did you consent to these activities?

 All BDSM activities involve consent. If your patient doesn't understand the phrase 'safe, sane, and consensual,` ask outright if the activities were consented to by both parties involved. If you ask the patient whether they consented, they will be more likely to divulge the information you are seeking.



Our Thanks And Appreciation To The Following Hospitals And Agencies For Their Assistance In Producing This Pamphlet:

 Mercy Hospital, Social Services Dept., Portland

 Maine Medical Center, Emergency Dept., Portland

Central Maine Medical Center, Emergency Dept., Lewiston

Franklin Memorial Hospital, Emergency Dept., Farmington

Midcoast Hospital, Social Services and Emergency Dept., Brunswick


Written by Ren, Dominant and Co-Founder of CUFSmaine, a Safe, Sane, and Consensual Alternative Lifestyle Support, Education and Social Group located in Portland, Maine.  

Ren is a BDSM safety educator.

Copyright 2000 Mistress Ren, may not be reproduced without permission.



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