An autoerotic asphyxia death in which the cross-dressed victim used duct tape, various ligature mechanisms, and freon gas. Autoerotic asphyxia is a type of intentional asphyxial activity that is typically, but not always, performed in isolation as a means of increasing sexual arousal and experience. Apparently, the relative hypoxia (decreased blood oxygen) associated with autoerotic asphyxia somehow leads to heightened sexual response. The typical participant is a relatively young adult male, although cases do occur in older men, and rare cases have been described in women. It should be stressed here that these cases represent accidental deaths, even though the initial appearance may suggest suicide. A frequent pronouncement during the initial police investigation is, “this is the strangest suicide I’ve ever seen.”

Fig.1 Autoerotic death with freon gas.

Autoerotic death refers to the accidental death of individuals of either sex due to failure of devices, or unexpected effect of materials, that were being used to enhance the sexual experience. Although asphyxia from hanging has been described most frequently, a wide variety of other lethal situations have been reported. As there is great variability in the number and types of sexual aids that may be used by individuals, careful death scene examination is essential in helping to exclude suicide and more rarely homicide. The clandestine nature of this paraphilia may, however, make subsequent identification and diagnosis difficult unless the death scene features are typical. This is particularly so in the rare cases involving women.

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